Application


Application Form
SECTION 1
CARD TYPE

Excellent Card


Premium Card – Silver Card



Premium Card – Gold Card


Premium Card – Platinum Card

 
MODE OF PAYMENT Cheque payee to Excel SLA (M) Sdn Bhd
Wire-transfer (TBA)
Paypal account paypal@excelsla.com
OTHER PLEASE SPECIFY
How do you know about Excel Card?
 
SECTION 2 – PERSONAL BIODATA
FULL NAME AS IN NEW IC
NEW IC
DATE OF BIRTH SEX
RACE Please Specify
ADDRESS

POSTAL CODE STATE
HOME NO. MOBILE NO.
EMAIL FAX NO.
 
SECTION 3 – PRODUCT INFO
Device #1



 
SECTION 5 – DEALER DETAIL
DEALER NAME
BRANCH/LOCATION
 
Terms & Conditions

  • The Excel Card is open to all Excel SLA Sdn. Bhd. (ESLA) customers above 18 years of age who agree to participate in the membership program.
  • Each Member will be issued a membership card upon registering with ESLA.
  • The Card is not a credit card or charge card.
  • The membership shall be terminated immediately upon:
       a. death of the Member
       b. termination of the Excel SLA subscribed by the Member

  • In the event that the membership is terminated (whether the termination is made by ESLA or the Member), all unredeemed points and rebates acquired under the Program prior to such termination will automatically become null and void.
  • ESLA reserves the right to decline issuance, or withrawal once issued, of the card when it deems necessary.
  • ESLA reserves the right to terminate the membership as and when it deems necessary and appropriate without giving any reason or notice.
  • ESLA reserves the right to suspend or terminate the program at any time as it deems necessary. Appropriate advance notice as determined by ESLA shall be given to the MEMBER.
  • ESLA reserves the right to omit, add or amend the terms and conditions without prior notice.
  • Any tax arising from a Member`s participation in the Program is the responsibility of the Member.
  • The Card is not transferable and is for the exclusive use of the Member only.
  • If the Card is stolen, lost or damage, a fee of RM5 will be charged for a replacement.
  • ESLA reserves the right to utilise information collected under the Program for promotional and marketing purposes.
  •   I have read, understood and agree to the above Terms & Conditions