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Online Enrolment

New enrolment added successfully!

Applicant Information

Title:

Please select

Distributor Name:

Preferred Name:

Full Name:
(as per MyKad)

IC No.:

Gender:

Please select

Race:

Race

Date of Birth:

Marital Status:

Please select

Preferred Language:

Please select

Spouse Information

Spouse Name:

Upload MyKad:

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IC No.:

Gender:

Please select

Race:

Please select

Date of Birth:

14/11/1980

Preferred Language:

Please select

Contact Details

Mobile:

Ex: 6012-3456789

Email:

Ex: email@shaklee.com

Tel. (Office):

(optional)

Tel. (Home):

(optional)

Spouse Mobile:

Ex: 6012-3456789

Permanent Address

Address 1

Select State

Select City

Select Postal Code

Correspondence Address

Address 1

Select State

Select City

Select Postal Code

Copy Permanent Address

Shipping Address

Address 1

Select State

Select City

Select Postal Code

Copy Permanent Address

Bonus Payout Information

Bonus Issued Type:

Electronic Funds Transfer

Bank Name:

Please select

Account Holder Name:

Account Number:

Upload Bank Statement:


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Sponsor's Information

Sponsor SID No.:

Sponsor Full Name:

Sponsor Name:

Temporary Password

Password:

●●●●●●●●●●●●●

Confirm Password:

●●●●●●●●●●●●●

Data Consent:
Consent from data giver - Personal Data Protection Act

Data Privacy:
This enrollee has consented for his personal information
to be entered into the Shaklee system.

Privacy Policy:
By clicking Submit, I confirm that I (i) accept the Terms
and Conditions, and (ii) consent to the processing of my
personal data by Shaklee Products (Malaysia) Sdn Bhd in
accordance with the Personal Data Protection Notice set
out in the Terms and Conditions.

Submit

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[301287-T]. All Rights Reserved.

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