BSN - Public Online Application

MyEzBSN

Customer Name*:
	*Please enter your full name.
Phone Number*:
	Phone number is 10 to 12 digits, starting with 6 (e.g: 60123456789*)
Email*:
	*Please enter your email. (e.g: email@gmail.com)
Employer Name*:
	*Please enter your employer name.
Product*:
	*Please select a product.
Applied Amount (RM):
	*Please enter an amount in multiple of thousand. (e.g: 2000)
State*:
	*Please select a state.
Branch*:
	*Please select a branch.
Select your preferred Financial Executive:	(Please click to select Financial Executive)

	*Please select a Financial Executive.
Declaration:
I hereby CONSENT and AUTHORISE the Bank to disclose and share my information for the purpose of cross selling, marketing and promotional activities with any party, including but not limited to the Bank's subsidiaries, service providers or strategic partners. I hereby DO NOT CONSENT and DO NOT AUTHORISE the Bank to disclose and share my information for the purpose of cross selling, marketing and promotional activities with any party.

I hereby acknowledge that I have read, understood, and agree with the terms, conditions, rules, guidelines and regulations as stated in the product's Terms and Conditions and/or Product Disclosure Sheet (whichever is applicable) provided in the Bank's website at www.bsn.com.my

I agree to above declaration.

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