Membership Signup

Things you should know :

  • NewLife Membership costs RM74.20
  • Details and signature collected will be used in 2 forms, Membership & PDPA.
  • Membership Form is the basic essential for signing up [Download PDF].
  • PDPA Form is an acknowledgment of your permission to receive the latest in promotions and updates from us [Download PDF].

Why be a Member?

Buy at member’s price about 25% off the retail.
On top of the member’s price, get bulk discounts.
Your friends can get member’s price under your name.
You get commission (that’s why we need your bank account details).
Get a bi-monthly LifeLine newsletter.
Get email updates on the promotions.
Free consultation.

Fields with orange borders are mandatory.

Applicant’s Details

Name as per IC
Usually the same name on the bank account for verification purposes.
Nick Name (if available)
Email Address
Mobile Contact
Office Tel
House Tel
Applicant’s IC or Passport Number
Date of Birth
Martial Status
Postal Code
Who introduced you

Bank Account Details

Should there be any rebates for NewLife purchases, it will be credited into this account.

Principal Name

Bank Name
Principal Account Number


  1. Sign your signature with a black pen on a clean white paper.
  2. Take a clear picture of the signature with the flash turned on.
  3. Whatsapp it to Stanley @ +6013-3470663 /

Handwritten signature’s required. So old-fashion right? Can’t be helped, this company is over 20 years old.

Your signature will be used only for the Membership & PDPA forms.


To order online, click here :