AYAM GEPUK TOK MAT LICENSING

Fill in the form below and build your business with us.

Full Name

NRIC Number

Phone

Address

Marital Status

Race

Location of Interest

Rental Range (RM)

Amount of Capital Available For This Business RM350,000 and Above

Yes

Annual Income

Have you ever been involved in any criminal record or legal action (lawsuit). Whether ongoing or resolved? If yes, please provide further details.

Yes

Please stated if your answer is "YES"

Total amount of funds available for investment:

RM 400 000

RM 500 000

RM 600 000

Location/Address Suggestion for JV Partners (Branch Opening):

I hereby confirm that the information stated above is true and accurate. I understand that false information may be grounds for not considering me or immediate termination of licensee at any point in the future if I am appointed.

Thanks for submitting! We shall contact you within 3 working days

If anything urgent you can click the button below:

Business Development

(Encik Zamri)

Tel: +60 12-3003801

Email: zamri@ayamgepuktokmat.com

(Encik Hakim)

Tel: +60 14-724 4153

Email: hakim@ayamgepuktokmat.com