COMPANY PROFILE
	Company Name Trading Name
	Status of Company (please choose one)
	i) Public Company v) Multi-Company ii) Limited Company vi) Franchise Holder iii) Partnership vii) Concessionaire iv) Sole Proprietorship
	Paid-up Capital Years of Operation Current Sales Turnover (per annum per sq. ft.)
	Business Correspondence Address
	Street State Kuala Lumpur Johor Kedah Kelantan Melaka Negeri Sembilan Pahang Penang Perak Perlis Sabah Sarawak Selangor Terengganu W.P. - Labuan W.P. - Putra Jaya Other State If ’Other State ‘ is selected, please fill in the field below:     Postcode Country Malaysia Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China China (Hong Kong S.A.R.) China (Macau S.A.R.) Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democractic Republic of the Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Islas Malvinas) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Korea, North Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles Netherlands, The New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua new Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe
	Telephone No. Mobile No. Fax No. Email Contact Person     Designation
	DETAILS OF BUSINESS OPERATIONS
	Main Nature of Business
	Main Outlet
	Branch Locations
	Consignment Counters
	Product
	Price Point
	Target Market
	Area/Size Required
	Preferred Floor
	*Special Requirement(s)
	Electricity
	Water
	Others (please specify)
	MISCELLANEOUS INFORMATION
	Please attach the following documents as supporting materials for our reference:
	- Photograph of Merchandise
	- Photograph of Current Store/Shop
	- Photograph of Shop Front /Display
	Name
	Date
	I declare that the above information given is true and correct.

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