Want to Retire In Malaysia

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REGISTRATION FORM

Thank you for your interest to retire in Malaysia. Before we proceed further with the registration process, we need the following details to be filled up and a deposit payment totaling USD$500.00 (refundable if for any reason your application is rejected by Immigration of Malaysia). We will keep your information confidential, and will not use your information for other purposes other than for the application of the MM2H program.

After filling up this Registration Form, you will see our online payment facilities through "StormPay". If you prefer to send your deposit through telegraphic transfer, kindly contact us for our Bank Account number.

Your Personal Information :

First Name
Last Name
Address 1
Address 2
Postcode
State
Country
Email Address

To safeguard the security of your information, we have captured your IP address, and will send it together with your submission. This is to avoid other people from using your information to register for this program.