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About Yourself :

Gender :  

Date of Birth:  

( Pls Tick ) 
:   Dining    Traveling    Shopping   



Email Address :  

Office contact:   (Tel)  (Fax)

Duration in
the Company

About Your Premiums Procurement Needs :

Purpose to Procure
( Pls Tick ) 
:   Trade Events    Advertising & Promotion   
  Annual Corp Function   
  Others (pls specify) : 

Premiums Given To
( Pls Tick ) 
:   Internal Staff    Distributors & Resellers   
  End Consumer    General Public   
  Others (pls specify) : 

Procurement Function
( Pls Tick ) 
:   Individual Department   
  Centralized Function   

Average Frequency
of Procurement  
(pls select)
:   Monthly    Quarterly   
  Bi-Yearly    Yearly   

What is the avr cost
of items procure?
(pls select)
: Less than $2
Less than $5
Less than $10
$10 to $20
$20 & above

What is the avr qty
purchased each time?
(pls tick)
: Less than 100 pcs
100 to 299 pcs
300 to 499 pcs
500 to 999 pcs
1000 pcs & above
What are the items you have procured over the last 3 to 6 months?:

About Your Company :

What industry your company operates in? :

Company set up is a :

Local or Regional office

International company with HQ base in Singapore

Global company with HQ base in Singapore

Global company with APAC HQ base in Singapore

Any other staff besides yourself procures in the company? :
Yes    No
If yes, kindly list down their names if they wish to be put under our mailing list :
1.    Dept:      Email:   

2.    Dept:      Email:   

3.    Dept:      Email:   

4.    Dept:      Email:   

5.    Dept:      Email: