Customer Registration From Taiping Agency Flex Reg - Referral 1ΔFull Name (as per IC/Passport)IC Number / PassportEmailWhatsApp / PhoneDate Of BirthGender Male Female OtherInterest To Join User / Merchant Register As Flex User Register As Flex MerchantMerchant NameMerchant AddressRemark I have read and agree to the Terms and ConditionsSubmit
