ZK Member Application Form

  Name :  __________________________________________        Sex :   M / F

 NRIC :  __________________________ Date of birth :__________________

 Tel. No. : _______________(HP) _______________(O) _______________(R)

 Mailing address :  _______________________________________________

  Email address :   ________________________________________________

 Signature :_____________________________Date :___________________

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  Please send the completed form to:

Nanjing Zhongke Biochemical Technology (S)

896 Dunearn Road

  #04-02A Sime Darby Centre

  S(589472)

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