Existing Bank Islam Customer *
Please choose a branch located near your place of work or home
Preferred State *
Preferred Branch *
Product *
Salary crediting with Bank Islam? *
Personal Information
(Full name as per NRIC)  *
Name
New IC Number  (Numbers only)
Other IC Number  
Monthly Income * (Numbers only)
Mobile Number * (Numbers only)
House Number
Email Address
Home Address *
Postcode *
City *
State *
Employment Information
Company Name *
Office Phone Number *
Office Fax Number  
Office Address *
Postcode *
City *
State *
Business Classification *
Designation *
Years in employment/business * (Numbers only)
Other Information
Amount Applied (if applicable) RM (Numbers only)
Remarks
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Notes:
1. For Saving/Current Account opening, please click here
2. Disclaimer: This is NOT a full application and Bank Islam will NOT use this for credit checking from the Bank's sources. Our personnel will contact you within the next business day to provide you with more information or help you set an appointment.