REGISTRATION FORM

* FIRST NAME

* LAST NAME

* GENDER

Male Female

* DATE OF BIRTH

* 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.