CLIENT REQUEST FORM

Please use CAPITAL LETTERS.

Requesting for:

Do you have an Employer?

Did you runaway from your Employer?

Are you willing to do the medical test?

The fomema is included in the package price but if your result online shows UNFIT, we can fix it with the amount of RM3,500.

But if you want a 100% sure that you will PASS it then an amount of RM1,800 to settle it.

CLIENT's DETAILS

Full name:

Address

Mobile

Date of Birth

Day

Month

Year

Passport No.

Issuance Date

Expiry Date

Job

Address in PH:

Delivery Address:

Passport Copy

Payment reflects the customer’s voluntary decision and agreement to engage Lapis Group’s services, made at their own discretion.
After payment is made, a request for cancellation can no longer be accepted. Lapis Group adopts a "no refund" and "no cancellation" policy for all its services.
Lapis Group is not liable for unforeseen circumstances that may arise from the use of our services.
Please carefully review our Terms & Conditions for important legal information and disclosures.

By using our service, you are agreeing to the Terms and Conditions mentioned above.

Signature

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