AEON Application
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Contact Details
Title
Select Title
Mr
Ms
Mrs
Dr
Full Name
Email Address
Aeon Express Member
yes
no
Aeon Credit Card Holder
yes
no
Personal Details
Other Identification
Select ID Type
Passport Number
Drivers License
NationalID
Other
Other Identification Number
Gender
Male
Female
Race
Select Race
Malay
Chinese
Indian
Others
Residency Status
Select Residency Status
Bumiputera
Non-Bumiputera
Marital Status
Select Marital Status
Married
Single
Divorced
Widowed
Number of Dependents (Kids)
Permanent Address
Address Line 1
Address Line 2
Address Line 3
Postcode
City
State
Residential Address Same as Permanent Address?
Yes
No
Residential Address
Address Line 1
Address Line 2
Address Line 3
Postcode
City
State
Residence's Ownership
Select Ownership Type
Employer's Quarters
Family Home
Live with Parents/Relatives
Own (Mortgaged)
Own (Not Mortgaged)
Rented
Others
House Phone Number
How Long Stayed at Current Residence
Emergency Contact
Title
Select Title
Mr
Ms
Madam
Dr
Datin
Dato
YB
Tan Sri
Name
Relationship
Mobile Number
Address Line 1
Address Line 2
Address Line 3
Postcode
City
State
Employment Details
Occupation Type
Select Occupation Type
Employed
Self-Employed
Position
Select Position
Asst Manager
Bar Tender/ Waitress/ Waiter/ Housekeeper
Cabin Crew
Clerical
Cleck (Despatch)
Cleck (Driver)
Cleck (Surveyor)
Driver/ Security/ Despatch
Executive II
Factory Worker
General Worker
GM/ AGM
Hawker/ Petty Traders
Insurance Agent/ Salesman/ Promoter
Junior Executive
Manager
MD and Above
Officer/ Executive
Others
Own Business
Pensioner
Police/ Navy/ Army/ Postman
Professional (Lawyer, Doctor, etc)
Senior Executive
Senior Executive II
Senior General Manager
Senior Manager
Skill Worker (Technician, Nurse, etc)
Supervisor
Taxi Driver
Teacher/ Lecturer
Department
Select Department
Account
Admin
Cargo
Clerk
Collection
Construction
IT
Management
Others
Production
Sales
Service
Technical
Business Nature
Select Business Nature
Administrative and Support Service Activities
Agriculture
Arts, Entertainment and Recreation
Banking/ Finance/ Credit
Construction
Education
Extraterritorial Organisations and Boodies
Healthcare
Investment
IT, Research & Development
Logistic
Manufacturing
Mass Media
Mining and Quarrying
Nature Business Code – Electricity
Other Service Activities
Others
Production of Domestic and Personal Services
Retailing & Wholesale
Semi Government & Government
Service Line (Hotel, Restaurant, Air Line, etc)
Water Supply, Sewerage, Waste Management
How long worked at current company
Year
Company Name
Office Phone Number
Company Address Line 1
Company Address Line 2
Company Address Line 3
Company Postcode
Company City
Company State
Financial Information
Gross Salary (RM)
Net Monthly Salary (RM)
Which day month receive salary
Source of Other Income
Select Source of Other Income
Insurance
Direct Selling
Business
Others
Other Income
Do you have any non-bank financial?
Yes
No
Payment Details
Mailing Address
Do you provide payment details?
Yes
No
Method of Payment
Select Payment Method
Auto Debit
Postdated Cheque
Salary Account
Yes
No
Bank Name
Account Number
File Uploads
ID File
Income File
Other File
Submit Application