Name

New IC Number

Mobile Number

Email

How do you know KOJADI Referrals Existing Members KOJADI Online Platform Roadshow SAME / SME Association Trade Association Newspapers Sales Activity Consultant Others

If others, please specify

Company Registered Name

Company Registration No.

Entity Business licensed by local authority Sole-Proprietor Partnership Private Limited Company Others

If others, please specify

Company Premises Address

Postal Code

City

State

Company Contact Number

Company Email

Nature of Business Agriculture Building and Construction General Commerce Professional Services Manufacturing Food and Beverage Transportation Others

If others, please specify

Years in Operation

Turnover / Revenue p.a. (RM)

Example: 10000.00

Number of Staff

Loan Amount To Apply (RM)

Example: 10000.00

Loan Purpose Working Capital Capital Expenditure Project Financing Machineries and Equipment Others

If others, please specify

Security question : 8 * 1 is

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