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  • PPEOC Membership Form

    Încărcat de

    Mazuan Mujail
    178 vizualizări2 pagini
    PersonaEleganceOwnerClub (PPEOC) website: www.ppeoc.my. Personal Details Name NRIC / Passport No. Date of Birth Place of Birth PPEOC Forum Nickname Correspondence Address Postcode State Country Gender : Male Marital Status : Single Job Post : Teacher Mobile No. : 0133924318.

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    PersonaEleganceOwnerClub (PPEOC) website: www.ppeoc.my. Personal Details Name NRIC / Passport No. Date of Birth Place of Birth PPEOC Forum Nickname Correspondence Address Postcode State Country Gender : Male Marital Status : Single Job Post : Teacher Mobile No. : 0133924318.

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    Attribution Non-Commercial (BY-NC)
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    178 vizualizări2 pagini

    PPEOC Membership Form

    Încărcat de

    Mazuan Mujail
    PersonaEleganceOwnerClub (PPEOC) website: www.ppeoc.my. Personal Details Name NRIC / Passport No. Date of Birth Place of Birth PPEOC Forum Nickname Correspondence Address Postcode State Country Gender : Male Marital Status : Single Job Post : Teacher Mobile No. : 0133924318.

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca DOC, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 2

    PersonaEleganceOwnerClub (PPEOC)

    Website: www.ppeoc.my
    Email : personaeleganceclub@gmail.com

    A. Personal Details

    Name : MAZUAN BIN MUJAIL


    NRIC/Passport No. : 861004235531
    Date of Birth : 04.10.1986
    Place of Birth : JOHOR BAHRU
    PPEOC Forum Nickname : Wan

    Correspondence Address : No.1, JALAN LAKSAMANA 8, TMN UNGKU TUN AMINAH


    : SKUDAI
    :
    Postcode : 81300
    State : JOHOR
    Country : Malaysia

    Gender : Male
    Marital Status : Single
    Job Post : Teacher
    Mobile No. : 0133924318
    Home : 075573209
    Office :
    Email :
    dezone5531@yahoo.com.my
    B. Vehicle Details

    Vehicle Registration No. : JMD 7211


    Car Maker : Proton
    Model : Persona Elegance
    Engine Capacity : 1.6 A
    Year manufacture : 2010
    Body Color : Bronze Garnet

    C. Sticker Order

    (Please select which sticker and quantity. Eg. Below)


    1) PPEOC Sticker (Road Tax Size):
    a. Bronze Garnet (1)
    b. Chiffon Green (0)
    c. Tranquility Black (0)
    d. Genetic Silver (0)
    e. Brilliant Red (0)
    2) PPEOC Rear Windscreen Sticker (0)
    D. Administration (For Administrator Use ONLY)
    Received (Date) : _____________ Membership No. : PEC________
    Approved (Date) : _____________ Effective Date : ___________
    Payment Received by : _____________ (Cheque/Bankin/Cash)

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