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Personal Information Survey
Terima kasih kerana berminat untuk mendapat rundingan daripada saya.
Bagi memudahkan saya membantu anda, saya memerlukan beberapa maklumat tentang anda.
Mohon isi maklumat berikut supaya saya dapat beri solusi yang tepat untuk anda
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* Indicates required question
How do you know about me? (Bagaimana anda tahu tentang saya?)
*
Facebook
Tik Tok
Instagram
Blog
Kenalan
Telegram
PERSONAL INFORMATION (MAKLUMAT DIRI)
Fullname (Nama penuh)
*
Your answer
Sex (Jantina)
*
Male (Lelaki)
Female (Perempuan)
Where is your location? (Di manakah lokasi anda berada?)
*
Your answer
Citizenship (Warganegara)
*
Malaysia
Others (lain-lain)
Birth Date (Tarikh Lahir)
*
MM
/
DD
/
YYYY
Phone Number (nombor telefon)
*
Your answer
Email address (alamat email)
*
Your answer
Are you a smoker? (Adakah anda seorang perokok?)
*
Yes
No
Marriage status (Status perkahwinan)
*
Single
Berkahwin
Bercerai
Number of children (Bilangan anak)
*
Your answer
Occupation (Pekerjaan)
*
Your answer
Salary (Gaji)
*
Below RM 4,000 (Kurang dari RM 4,000)
RM 4,001-RM 9,000
RM 9,001 - RM 30,000
More than RM 30,000 (lebih dari RM 30,000)
Hobby (hobby)
*
Your answer
If you have existing illness, please state. (Sekiranya anda mempunyai penyakit sedia ada, sila nyatakan)
Your answer
Are you looking for what type of protection plan? (Anda mencari jenis pelan perlindungan yang bagaimana?)
*
Medical Card Plan (Pelan kad perubatan)
Income Replacement plan (Pelan penggantian pendapatan)
Investment plan (Pelan pelaburan)
What is your priority? (Apakah keutamaan anda?)
*
Lifestyle (Gaya hidup)
Saving and Investment (Simpanan dan pelaburan)
Retirement (Persaraan)
House (Rumah)
Children Education (Pendidikan anak-anak)
Medical needs (Keperluan perubatan)
Parents (Ibu bapa)
Are you looking takaful protection for (Anda mencari pelan takaful untuk)
*
My self
Me and my family
Me and my child
Me and my wife
My parents
If only you will be covered in this plan, you don't have to answer next questions. (Sekiranya hanya anda orang yang dilindungi untuk plan ini, anda tidak perlu menjawab soalan seterusnya)
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