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JOHN CONNECT SERVICE – CLIENT REGISTRATION AND SERVICE REQUEST FORM
SECTION 1 – PERSONAL INFORMATION
First name
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Middle name
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Surname
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Date of birth
*
Country of birth
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Nationality
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Country of current residence
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Full residential address
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City and state/province
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WhatsApp/contact number
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Email address
*
SECTION 2 – SERVICE REQUEST
Service required
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Describe the service required
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Expected completion or travel date
*
SECTION 4 – EDUCATION AND WORK EXPERIENCE
Highest level of education
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Name of school or institution
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Upload education certificate
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Click to choose a file or drag here
Size limit: 10 MB
Handwork, occupation, trade or professional skill
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Years of experience
*
Upload CV or work certificate
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Click to choose a file or drag here
Size limit: 10 MB
SECTION 5 – PAYMENT INFORMATION
Total agreed service fee
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Currency
*
Amount already paid
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Outstanding balance
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Balance payment due date
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Payment method
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Payment date
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Transaction reference
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Upload payment receipt
*
WARNING:
Never provide your bank password, card PIN, CVV or OTP on this form. JOHN CONNECT SERVICE will never request these confidential security details.
SECTION 6 – DECLARATION AND CONSENT
I confirm that the information and documents submitted are correct and genuine.
I authorize JOHN CONNECT SERVICE to use my information and documents only for the service I have requested and to share them with relevant official authorities or service partners when necessary.
I understand that submitting this form or making payment does not guarantee a visa, job, admission or government approval.
I have read and accepted the company’s service and payment conditions.
Client’s full name as electronic declaration
*
Electronic signature
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Signature
Date of submission
*
Submit