ChargEV Online Registration Form

01. Personal Information

Full Name

* as per MYKAD or Passport

Identification Number

* Use passport number for non-citizen
* For citizen, IC must be numbers only, no '-' or spaces.

02. Contact Information

Address Line 1

Address Line 2

* Please provide a valid mailing address for card delivery

Postcode

City

State

Phone Number

* Numbers only no '+', '-' or spaces.

Email Address

03. Vehicle Information

Vehicle Manufacturer

Vehicle Model

Vehicle Registration Number

Dealer Name

Sales Advisor Name

Year Registered

Car Chassis / VIN Number

Scanned Photo of Driving License

* Photo must be readable in JPEG, GIF and PNG only

Are you the owner of this vehicle? Yes, I owned this vehicle No, I lease this vehicle No, this is a company vehicle

04. Business Arrangement

Please provide your preferred RFID card & car sticker collection arrangement.

Self-Collection

The RFID card & the windscreen car sticker will be ready to collect within 10 working days. Visit GreenTech Malaysia office at No. 2 Jalan 9/10, Persiaran Usahawan, Seksyen 9, 43650 Bandar Baru Bangi Selangor from Monday to Friday, 9AM to 5PM (except lunch hour at 1-2PM) Please email or Whatsapp to 011-23373387 for collection your card at our reception desk. Waze Malaysian Green Technology Corporation for navigation.

Delivery via Post

The RFID card & the windscreen car sticker will be delivered as per your registration address within 14 working days. Ensure your registered address is valid & there is someone to receive the delivery. Please note that the delivery chargers is RM15.00 and payment to be made to Malaysian Green Technology Corporation (account number 8600434621 CIMB Islamic Bank Berhad).

05. Terms and Condtions

You must agree to the terms & conditions in order to become a ChargEV member. I understand that The RFID card & the windscreen car sticker will be ready to collect within 10 working days. I will email or Whatsapp to 011-23373387 for enquiries.

ChargEV charging station does not come with Type 2 to Type 2 charging cable. Please use your personal Type 2 to Type 2 cable.

YES, I will ensure my car is connected when using the designated parking area and the maximum charging is 2 hours only.

I hereby certify that, to the best of my knowledge, all the information provided in this form is true and correct.

YES, I have read, understood and accept the terms and conditions.

YES, I have read and understood the GreenTech Malaysia Privacy Policy, and I consent to my personal data, being processed and used by GreenTech Malaysia for the purpose indicated in the GreenTech Malaysia Privacy Policy.

YES, I would like to be kept informed about what ChargEV doing.

Registration Form

01. Personal Information

02. Contact Information

03. Vehicle Information

04. Business Arrangement

05. Terms and Condtions

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