DAIKIN Installer Application Form

DTC Member Registration Form

Installer Information

You are registering from*

Company Name*

Company Name* required Minimum length required Invalid Format

Name (NRIC)*

Name (NRIC)* required Minimum length required Invalid Format

National IC*

example 880121-14-6624 National IC* required Minimum length required Invalid Format IC already exist

Installer Type*

Address Line 1*

Address Line 1* required Minimum length required Invalid Format

Address Line 2

Address Line 2 required Minimum length required Invalid Format

Address Line 3

Address Line 3 required Minimum length required Invalid Format

City

City required Minimum length required Invalid Format

Postcode*

Postcode* required Minimum length required Invalid Format

State*

Email required Minimum length required Invalid Format

Mobile Phone 1 *

example: (016)3028888

Android

iOS

Mobile Phone2

Android

iOS

Referral MemberID

Referral MemberID required Minimum length required Invalid Format

Referral Name

Referral Name required Minimum length required Invalid Format

I agree to all the term and condition

With the enforcement of the Personal Data Protection Act 2010 ("PDPA") since November 2013, we, at DAIKIN Group of Companies in Malaysia. wish to inform you that we are committed to the protection of our customers’ and business partners’ personal information. Please visit http://www.daikinmalaysia.com/privacy-policy to view our Privacy Notice. Unless you have otherwise notified us in writing, we will presume that you have read and consented to our processing of your personal data as set out in the Privacy Notice

Thank You For Your Registration

We will process your application within 1 working day

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