Personal Information 个人资料

Please ensure that you provide accurate information. 请确保您提供准确的信息
We will use the details provided to contact you. 我们将使用您提供的详细资料与您联系。
Note: This form is open to Malaysians aged 30 and below who are enrolled at a university/college.
注意: 此表格适用于年龄在30岁以下，在大学/学院就读的马来西亚学生。

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* Name 姓名
(as per-NRIC)

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* NRIC 身份证号码
(eg: 02xxxx-14-xxxx)

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* Gender 性别

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* Contact No. 联络号码
(eg: 01X-XXX XXXX)

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* Email address 电子邮件

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* Ethnic 种族

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* Residential Address 居住地址
(Please ensure enter the city, state and postal code 请确保填写城市、州和邮政编码)

Data Protection Notice
By submitting your application, you agree, authorise and consent to provide your personal information to Great Eastern Life Assurance (Malaysia) Berhad ('Great Eastern Life') and its group of companies. Your personal information may be used, recorded, stored, disclosed or otherwise processed by or on behalf of Great Eastern Life and its group of companies for the purpose of communicating with you through but not limited to email mailing list, career opportunities and marketing updates.
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