Murang Motor

Full Name

(Kumpletong pangalan na nasa ID card)

Given Name *

Middle Name *

Family Name *

Preferred Address to Visit you & Contact Details

Address Type *

House Number

Street / Purok

Province *

Town/City *

Barangay *

Mobile Number *

Facebook Account *

Email Address

Preferences

Preferred Brand *

Preferred Model *

Preferred Date to be Called / Visited *

Preferred Time to be Called / Visited *

Bilang pagtugon para sa maayos na proseso, nais muna namin kunin ang inyong pahintulot sa mga sumusunod:

Pursuant to the Data Privacy Act of 2012 and its implementing Rules and Regulations, I express my consent for ROPALI Corporation and its affiliate companies to use, collect, record, and consolidate my personal data for information, which shall be used for the purpose of processing my online motorcycle application.

For more details, the client is requested to read: https://ropali.ph/ropalidataprivacy/