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Kindershield Registration Form
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* Indicates required question
Company Name
*
Your answer
Name of person in charge
*
Your answer
Total Branches
*
1
2
3
Other:
Business Address
*
Your answer
Estimated Student Population
*
Less than 50 pax
50 to 100 pax
More than 100 pax
Mobile Number
*
Your answer
Email Address
*
Your answer
Plan that you would like to choose
*
Kindershield BIZ
Kindershield BIZ plus
Kindershield PA
Director & Officer
Required
Deposit paid by
*
Cash
Credit card/Debit card
Online banking
QR pay/ewallet
Bank acc number:
Public bank
3989974333
My Elink(M) PLT
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