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Life Partner E-Card Application Form
Parent's Details
Residential Address
Children's Details (1)
Children's Details (2)
Children's Details (3)
Children's Details (4)
Other Details
Payment Methods
1.Cash Payment.
2.Credit Card Payment.
3.Cheque Payment, please made payable to Azon Connect People Development Sdn Bhd and send to our centre.
4.Bank Transfer Payment, please pay to Public Bank A/C No: 3202636531. Please Whatsapp the bank-in slip to our centre.

E-03-22 IOI Boulevard, Jalan Kenari 5, Bandar Puchong Jaya, 47100 Puchong, Selangor, Malaysia.
Mobile No: +6019-231 7154 (Service/Event Inquiry, Feedback & Suggestion)
Fax: 03-8063 8425
Email: info@azon.my
Website: www.azon.my
Parent Declaration
I have read the terms and conditions, and I agree upon all the rules and regulations.

In the event that there is any variation in Full Name and Birth Certificate/Identity Card Number between Azon's form submissions and Birth Certificate/Identity Card, the Birth Certificate/Identity Card shall prevail.