MORINAGA CHIL-KID 700G TRIAL PACK VOUCHER APPLICATION

Morinaga Chil-kid is formulated with a balanced ratio of AA & DHA, fortified with GOS, and well sufficient amount of 5 Nucleotides, to provide the optimal nutrients for young children from 1 year and above. Morinaga Chil-kid with GOS benefits the bowel function by stimulating the growth and activity of the beneficial bacteria in the colon. It helps to increase defecation frequency and hence it can help to alleviate constipation in children.

MOTHER INFORMATION

Mother's Name (as per IC)

Contact No

Nationality

Mother's IC (881111-11-2222)

Please fill in a valid IC.

Passport No.

Mother's Date Of Birth

Email Address

Address

Post Code

State

Race

Work Industry

Professional Level

CHILD(REN) INFORMATION

According to Ministry of Health Malaysia, the Malaysian Dietary Guidelines encourage exclusive breastfeeding from birth until six months or beyond. Therefore, we are unable to process your voucher application. However, we will contact you to explain our product’s information.

Number of child(ren)

Applicant's Current Brand

Applicant's Name

Applicant's Date Of Birth

2nd Child's Name

2nd Child's Date Of Birth

3rd Child's Name

3rd Child's Date Of Birth

4th Child's Name

4th Child's Date Of Birth

GENERAL INFORMATION

Preferred Outlet

Outlet Address

OFFICE USE

ME code

TP Taken

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