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Date of Birth Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 - Month Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec -
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Employment
Income -- Please Select Income Range -- RM 1,000 and below RM 1,001 - RM 3,000 RM 3,001 - RM 5,000 RM 5,001 - RM 7,000 RM 7,001 - RM 9,000 RM 9,001 and above
Interests
Shop Online Before Yes No
Surf Internet Frequently Yes No
Places Usually Surf Internet
Preferred Portal Services -- Please Select Portal -- Google MSN Yahoo Others
Suggestions
Site Improvement Yes No
