RBS Individual Member Application

Type of RBS Membership *

Full Name as in NRIC *

NRIC / Passport No. *

Date of Birth *

Gender *

Marital Status *

Correspondence Address *

Contact Number *

Email *

Tax Identification No. (TIN) - for e-invoicing purpose *

Lembaga Hasil Dalam Negeri Malaysia (LHDN) Website

Upline Code (If you have an upline)

REP Code (Optional, if you are REP)

Are you an existing Rockwills Franchisee? *

Referral Commission / Payment to

Name of Bank Account Holder *

Bank Account Holder NRIC / Passport *

Name of Bank *

Type of Account *

Bank Account No. *

Bank Branch *

Declaration

By submitting this form, you declare that the details are true and accurate to the best of your knowledge and you agree to abide by the terms and conditions for the membership. You further declare that you are not a bankrupt or had any previous criminal convictions.

Payment Options

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Manual Bank-in

Bank: CIMB Bank
Account No.: 8000 9276 85
Account Name: BUSINESS SOLUTIONS SDN BHD

You may bank-in using the details above, or scan the QR code.

Payment Receipt (Image/PDF) *

Upload your bank-in/transfer receipt. Images or PDF accepted. This field is required.