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Full name*	IC no
	- -
Gender*	Email Address*
MaleFemale
Password*	Confirm Password*
Mobile No*	Race*
---010011012013014016017018019	Please selectMalayChineseIndianOthers
Age*	Profession
Please selectBelow 2020-2930-3940-4950 and above
Correspondent address	State	Postcode
	Please selectKuala LumpurLabuanPutrajayaJohorKedahKelantanMalaccaNegeri SembilanPahangPerakPerlisPenangSabahSarawakSelangorTerengganu
What type of house do you live in?	What brand of paint did you use previously?
Please selectCondoApartmentFlat SingleDouble-storey Terrace House Semi-DBungalow	Please selectNippon PaintICI DuluxJotunColourlandOthers (pls specify)
What brand of paint do you plan to use?	When do you plan to paint your house?
Please selectNippon PaintICI DuluxJotunColourlandOthers (pls specify)	Please select1-3 years3-5 years5 years laterNo plan
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