Portable Container System Solution for Petrol Station

Dealership Application

Choose Application Type

Section A: Applicant Details

Full Name
IC Number
Gender
Age
Current Job/Position
Mailing Address
City
Postcode
State
Phone (Office)
Phone (H/P)
Email

Section B: Company Details

Company Name
Reg No
Business Activity
Company Address
City
Postcode
State
Company Phone
Company Fax
Company Email

Section C: Proposed Location (if available)

Location Address
District
Postcode
State
Owner Name
Ownership Type
Land Status
Area Size (Sq ft)
Other Information