| Full
name as in IC or Passport |
|
| Name
to appear on card |
(Not more than 15 letter) |
| Date
of Birth |
|
| Place
of Birth |
|
Nationality
|
|
|
Current Residence |
|
| Post
Code |
|
|
Country |
|
| Phone
no. |
|
| Fax.
no. |
|
| Email
Address |
|
|
|
EMPLOYMENT DETAILS |
|
Name of Employer /Company |
|
|
Nature of Business |
|
|
Position Held |
|
|
Current Office Address |
|
| Post
Code |
|
|
Country |
|
| Phone no. |
|
| Fax
no. |
|
| Email
Address |
|
|
PLEASE ANSWER THE FOLLOWING QUESTION |
|
How often do you use car rental? |