ONLINE REGISTRATION FORM If you would like to be updated on the latest projects by Hillcrest Gardens Sdn Bhd, please register your interest by completing the form below. (Field marked with * is compulsary) Section A 1. Project Interested *           Taman Puchong Utama   Seri Gombak     2. Property Type Interested * (Select at least 1 to proceed)           a. Residential Built-up Area Preferred           Semi-Detached sq.ft.           Bungalow sq.ft.           Apartment/Condominium sq.ft.           Townhouse sq.ft.           Double Storey Link House        Lot Size Preferred :         18' X 60' sq.ft.       22' X 75' sq.ft.           b. Commercial             2-Storey Shops (22' X 75') 3-Storey Shop-Office (22' X 75')               Shopping Complex :             Office Space (Buy) Office Space (Rent) Lot Size Required  sq.ft.   Type of Business                Retail Space (Buy) Retail Space (Rent)   Lot Size Required  sq.ft.   Type of Business      3. For Apartments/Condominiums/Townhouses*           a. Facilities Preferred                 Basic Facilities :             24-Hours Security Children's Playground           Vehicle Auto Barrier Access                 Additional Facilities :             Swimming Pool Reading Room/Library           Gymnasium Built-in Broadband Connection           Badminton Court Sauna           Intercom System Tennis Court           Children's Wading Pool Multi-purpose Hall           Squash Court             Others : (Please Specify)           b. Which Would You Prefer                 Want the basic facilities only and pay for lower maintenance charge           Want additional facilities and will pay for higher maintenance charge     4. Budget For Property *           My Budget is : Select One RM150,000 And Below RM150,001 - RM250,000 RM250,001 - RM350,000 RM350,001 - RM450,000 RM450,001 - RM650,000 RM650,001 - RM1million RM1million And Above     5. Financing *           Type of Financing Select One Own Funds Government Loan Bank Loan       Others : (Please Specify)     6. Purpose of Purchase *           Purpose of Purchase Select One Own Occupation Investment     7. How Did You Hear About Our Projects? *             Website Signboards Leaflets       Friends Buntings Email       SMS Exhibition Banners       Newspapers :           The Star Berita Harian Sin Chew Jit Poh       China Press Nanyang Siang Pau         New Strait Times Utusan Malaysia        Others : (Please Specify)       Section B Personal Particulars     Name : * Mr Ms Mrs NRIC (new) : Profession : * Address : * State : * Postcode : * Country : * Choose a Country United States of America Canada Germany France United Kingdom India --------------------- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocoa (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote Divoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Lao Peoples Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallisw and Futuna Islands Western Sahara Yeman Yugoslavia Zaire Zambia Zimbabwe Not Listed E-Mail : Telephone : * Office House Mobile Fax : Present House : * Select One Own Rented Family Others : (Please Specify)