COMPANY & ADDRESS
Company*
:
Company Registration Number*
:
Company Address*
:
City*
:
Postcode*
:
State*
:
Telephone Number*
:
Please input valid Contact Number : eg. +6016XXXXXXXX
Fax Number
:
Website ( http:// )
:
Business Details
Number of Employees*
:
Core Business*
:
Other services provided*
:
What other brand(s) do you sell now?*
:
Do you currently supply any antivirus solutions?*
:
If Yes, Kindly specify brand
:
* Note: Maximum file size for upload is 4MB/file.  
Copy of Directors IC*
:
(*accept png, jpeg, jpg, pdf, microsoft word, microsoft excel, microsoft powerpoint, zip, rar)
PRIMARY CONTACT PERSON
 
Name*
:
Email*
:
Designation*
:
Mobile Number*
:
Please input valid Contact Number : eg. +6016XXXXXXXX

SECONDARY CONTACT PERSON
 
Name*
:
Email*
:
Designation*
:
Mobile Number*
:
Please input valid Contact Number : eg. +6016XXXXXXXX

ACCOUNT CONTACT PERSON (Finance)
 
Same as*
:
Name
:
Email
:
Designation
:
Mobile Number
:
Please input valid Contact Number : eg. +6016XXXXXXXX

Form Submitted by
 
Same as*
:
NOTE: The below email address will be receiving a copy of the submission info.
Email Address*
:
Declarations*
:
Should you require further assistance, please email to sales-my@tech-titan.com and do not hesitate to contact us at +603-7802 2288.

Copyright © 2023 Tech Titan Distribution Sdn. Bhd. Reg. No. 201001000411 (884981-W). All Rights Reserved.
Address:   Wisma Tech Titan, BO3-C-15-1, Menara 3A, No. 3 Jalan Bangsar,
KL Eco City, 59200 Kuala Lumpur, Malaysia.

Web:  www.tech-titan.com   Email: sales-my@tech-titan.com     Tel: +603 2383 8331   Privacy :  Privacy policy