Email Application Form
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Dear customer,

For us to register you as a new email user, we need the following 
confirmation and documentation. Kindly fill in the correct information 
and courier/fax to us together with all the necessary support documents.

************************ Please Print This Form **************************

Organisation Information
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Name			:	________________________________
I.C / Passport No.	: 	________________________________
Position		:	________________________________
Organisation		:	________________________________
Address			:	________________________________
				________________________________ 
Telephone		:	________________________________
Fax			:	________________________________



JARING Email Account Preferences
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UserID

* We encourage you to use your company name as the UserID.
* This ID will be use as your email address
* It should contain 3 to 7 characters only.
* Your ID must be in lower case.
* Example: If your company is ABCDE Sdn. Bhd. Then you may use abcde as 
  your user ID. Your email address will be abcde@po.jaring.my
* Just in case that others have used your UserID, please provide 3 
  different UserID and we will register your UserID in preference order.

Option1: _______________ Option2: _______________ Option3: _______________

Password

* Your password should contain 5 to 8 characters.
* You can have a mixture of lower case and upper case plus numeric 
  characters.
* This password will be your secret password for connection to JARING and
  access your email account.
* Example: abcde123, AbCdE123, ABCDE123,

Your password: _____________

Please enclose a copy of your Company Registration Certificate (Borang 9)

After completing this form, please fax to us at : 03-4974430
or mail to us : Business Systems Development Sdn. Bhd.
		3, Jalan Bunga Tanjung 8B, 
                Taman Putra Ampang,
                68000 Selangor.

If you encounter any problems or difficulty when filling this form, please 
do not hesitate to our Internet Support Representative Mr. Yan at 03-4974429.