Temporary Distributorship Application Form

Applicant's Particulars

*	Applicant's Name
		Male Female
*	Date of Birth	- - (eg. DD-MM-YYYY)
*	Address
*	House Tel NO.	-

*	Please indicate Your Account NO.
	- (Bank-Account NO.)

* Nationality
*I.C. NO./Passport NO.

* Post Code
	* H/P NO.	-
	* Office Fax NO.	-

*	Spouse Name
		Male Female
*	Date of Birth	- - (eg. DD-MM-YYYY)
*	Address

	* Nationality
* I.C. NO./Passport NO.

	* Post Code

Sponsor's Particulars

Sponsor's Name

* Sponsor's NO.

Subscription Fee Form

* I Agree * Disagree to pay RM20 (BS / S$10) by

for payment of yearly subscription fee, 3 months before my membership expired date.

I understand theat even my application had accepted for the appointment of an independent distributor of M-Plan, this appointment does not make me an employee or legal representive of the company. No unauthorised claims and representations or statements made by me. I agree to comply with all the rules of conduct as set forth in official M-Plan litreature and manuals. I agree that M-Plan reserves the rigth for any alteration and addition of the M-Plan marketing plan, code of ethics and rules of conduc for further expansion of M-Plan business from time to time.