Complete and fax to Qube Integrated (M) Sdn Bhd, +603-62773973.
For more details, please contact Ms. Lorela Chia 012-278 3899 or Ms Hani 019 - 720 3137.
| Name:__________________________________________________________________________ |
| Job Designation:________________________ |
Handphone:______________________________ |
| Company:_______________________________________________________________________ |
| Address:________________________________________________________________________ |
| City:__________________________________ |
State:___________________________________ |
| Postcode:_____________________________ |
Country:_________________________________ |
| Tel:__________________________________ |
Fax:____________________________________ |
| E-Mail:_________________________________________________________________________ |
| Nature of Business:_______________________________________________________________ |