Welcome to VICOM Lucky Draw
 
VICOM Solution for Inspection Requirements (V-SIR)  Form
Vehicle Number *  
Vehicle Status  
First  Name *  
Last  Name *  
N.R.I.C.  *   
Date of Birth (DD/MM/YYYY) *
Gender *  
Car Owner *
Mobile Number *  
Email Address  
If you would like to receive Insurance reminders, please fill in the following:
Insurance Provider
Insurance Month Due  
    * Mandatory Fields
 
By completing the Registration Form, I agree to the Terms and Conditions of VICOM Solution for Inspection Requirements (V-SIR)  and  the Register 'n' Win lucky draw. In addition, I give consent to the collection, use and
disclosure of my personal data as provided in this Registration Form
   
   (a) by VICOM, for the purposes of administering the weekly lucky draw and/or the Grand Draw, including to contact  me for the administration of prizes in relation to the lucky draw, and  
   (b) by HL Assurance Pte Ltd (“HL Assurance”), for the purposes of providing and/or administering the Complimentary Home Contents Insurance by HL Assurance through contacting me under the Program and to send me marketing and promotional information and materials via posts and/or emails.