New Houz Card Application
Renewal
Houz Card No.
I want to redempt my Houz Card at
-- Please Select --
Plaza Pelangi Astana, PJ
Jalan TAR, KL
Personal Information:
*
Name in full (Dr/Mr/Mrs/Miss)
*
Name to appear on Houz Card
*
New IC / Passport No.
*
Nationality
*
Date of Birth
dd
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
mm
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
yyyy
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
*
Sex
-- Please Select --
Male
Female
*
Marital Status
-- Please Select --
Single
Married
*
Race
Malay
Chinese
Indian
Others
*
Correspondence Address
City
State
Postcode
Contact No.
*
Home
(eg. 03-1234567, please enter 031234567)
Office
(eg. 03-1234567, please enter 031234567)
*
Mobile
(eg. 013-1234567, please enter 0131234567)
*
Email
(eg. abc@xyz.com)
*
Profession
*
Gross household income
< RM2,000
RM2,001 - RM4,000
RM4,001 - RM6,000
RM6,001 - RM8,000
RM8,001 - RM10,000
> RM10,000
*
Type of residence
Do you like DIY?
Yes
No
Do you like home improvement?
Yes
No
Are you going to move into a new house?
Yes
No
*
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I agree to participate and abide by the HOUZ CARD Terms & Conditions. I accept that any decision made with regards to this membership will be final and no correspondence will be entertained.