EN
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中
EN
|
中
REGISTRATION FORM
(*) REQUIRED FIELDS
* FIRST NAME
* LAST NAME
* GENDER
Male
Female
* DATE OF BIRTH
Year
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
Month
1
2
3
4
5
6
7
8
9
10
11
12
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
* NATIONALITY
COMPANY NAME
JOB TITLE
* MOBILE
* E-MAIL
* ARE YOU A MACAU RESIDENT?
Yes
No
* CAN WE CALL YOU TO CONFIRM YOUR IDENTITY?
Yes
No
09:00 - 14:00
14:00 - 21:00
* HOW DID YOU HEAR ABOUT US?
FRIENDS
SEARCH ENGINE
SOCIAL MEDIA
OTHERS (PLEASE SPECIFY)
* ARE YOU AN ONLINE SHOPPER?
Yes
No
HOW OFTEN DO YOU SHOP ONLINE?
EVERYDAY!
ONCE A WEEK
ONCE A MONTH
RARELY
* I LIKE...
NEW STYLES
LIMITED EDITION
LOW PRICED CLOTHING
BRANDED ITEMS
ORIGINALITY
QUALITY
OTHERS (PLEASE SPECIFY)
I, hereby confirm that all information above is correct and accurate.
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For further enquiries, please contact us at
customercare@alluremacau.com
