Membership form

For Seller Use

Seller Code:
Have a Promo Code?

Promo Code:
 
 

Membership Information


Full name:
Email Address:*
Effective Start Date (date / month / year):*
Effective End Date (date / month / year):*
H/P No: *
Car Registration Plate No: *
 
 

Member Pay By*


Credit Card/ Debit Card / Online Banking
 
 

Membership Plan Selection


Value (RM 60.00 For 1 Year)
Super (RM 100.00 For 1 Year)
VIP (RM 200.00 For 1 Year)
Supplementary (RM 60.00 For 1 Year)
Bike2ResQ (RM 200.00 For 1 Year)
Bike2ResQ + Supplementary (RM 260.00 For 1 Year)
Short Term Road Assist (RM 12.00 For 7 Days)
HONDA Bike2ResQ (RM 160.00 For 1 Year)
 
 

Payment Summary


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To Proceed, please agree to the following: