FORMULIR DAFTAR RESELER BARU

KEUNTUNGAN MENJADI RESELER KAMI

"Bisnis Online Gak Pake Ribet, Semua Bisa Menghasilkan Uang"

Itu Semua Kamu Bisa Daftar Secara GRATIS!

SYARAT & KETENTUAN

GENRE

Bisa pilih lebih dari 1 produk yang ingin kamu jual
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KTP

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NIK
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DATA DIRI

Nama Lengkap
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Email
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Facebook
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Instagram
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Jenis Kelamin
  • Pilih
  • LAKI-LAKI
  • PEREMPUAN
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Whatsapp
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No Telp
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Pekerjaan
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Media Social
bisa lebih dari 1
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DATA ALAMAT

(Isi alamat domisili / toko untuk pengiriman)
Alamat:
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No Rt
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No Rw
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Provinsi
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Kabupaten
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Kelurahan / Desa
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DATA BANK KLAIM PENGHASILAN

( Bila terjadi kesalahan bukan tanggung jawab manajemen )
Kepemilikan Rekening
  • Pilih
  • Milik Pribadi
  • Bukan Milik Pribadi
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Nama Rekening
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Nama Bank
  • Pilih
  • BNI
  • MANDIRI
  • BRI
  • BCA
  • BSM
  • BRI SYARIAH
  • BNI SYARIAH
  • BANK SINARMAS
  • BTN
  • BANK JATENG
  • BANK RIAU
  • BANK PERMATA
  • BANK SULUT
  • BANK MANDIRI SYARIAH
  • MAYBANK
  • BANK MUAMALAT
  • BANK KALBAR
  • BANK SUMSEL BABEL
  • BANK JAMBI
  • BANK BTPN
  • BANK NAGARI
  • BANK KALTIMTARA
  • BANK GANESHA
  • BANK PANIN
  • BANK BJB
  • BANK CIMB NIAGA
  • BANK HANA
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Nomor Rekening
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DATA SUMBER INFORMASI

Sumber Informasi
  • Pilih
  • Pribadi
  • Agen / CS Agen
  • Facebook
  • Instagram
  • Youtube
  • Teman / Saudara
  • Lainnya
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