Sign In Infomation
Username *
Password *
Re-password *
Essential Infomation of Applicant
Fullname *
Gender
Date of birth *
Nationality
ID | Passport *
Email
Receipt of Info?
Home Address
Receipt of Info?
City
District
Ward
Offcice Address
Receipt of Info?
Street
City
District
Ward
Telephone*
Receipt of Info?
Optional Infomation
Occupation
Marital status
Age of Children
Car Ownership
Car brand
Golf membership
Golf club
Recommend person
I hereby consent to the Terms and Conditions of LOTTE DEPARTMENT STORE Members Card Service and confirm that all information herein is true and correct.