ATOMY MEMBERSHIP APPLICATION (ms-01-03) MemberName: MARCELLA @BINTI SILUN Member io: lOF636(F | contact No OII-19S15834 ic/PReard No: — 8609OG- 12-5206 Email: marellasilun © yakoo - cow [sponsor Name: Rusaind Bit) GAS sponsor iD: 10253384 ase place original IC/PR card (front side only) on the column provided, take a picture of + form and upload the file through www.atomy.kr/m/mload_my reby consent and certify that the information given above is true and correct to the best of my wledge. | understand that a false statement may disqualify me for benefits. By signing below, | ee to register as a member of Atomy Malaysia Sdn. Bhd, nature GO IME ga, 2 TAME omy Malaysia Sdn. Bhd. (11397264) Suite 18.1, Level 18 of Wisma Nusantars, Jalan Funcak Off 11 Ramlee, 50250 Kuala Lumpur, Malaysia 1503 2718 6999 Fax. +503 2718 2968 website: www stomy.com/my