Firstcoach - Coach & Travel One-Stop-Shop

	24 May 2013

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Members Registration

Personal Info
*Name as in I.C
*Preferred Name	(correspondence use)
*Password
*Confirm Password
*New IC
*Date of Birth	(yyyy-mm-dd)
*Gender
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Preferred Language
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*Racial
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Passport Expiry Date	(yyyy-mm-dd)
Place of Issue
Place of Birth
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Contact Info
*Address


Zipcode
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*Country
*Primary Phone
Secondary Phone
Other Phone
*Email

Other Info
Preferred Seats

Agreement and Terms of Services
YES I AGREE. I had read through and hereby agree to the terms laid out in the Agreement .
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