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Profile Details
System Info
Gold Account*	Minimum 4 characters and must start with at least 3 alphabets and then use only alphabets, numerals and "-" sign with no space.
Introducer's GA*	GAID
Reference GA*	GAID
Reference GC*
Desired Side	Left     Right
Location Info
Country*	<Select> Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Cote d Ivoire Croatia Cuba Cyprus Czech Republic Dagistan Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Islas Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern and Antarctic Lands Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City) Honduras Hong Kong (SAR) Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Man, Isle of Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Bahamas The Gambia Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wallis and Futuna Western Sahara Yemen Yugoslavia Zambia Zimbabwe
City*	<Select> If your desired city is not present in the list, please select the nearest one and send message to admin using our Email Support.
Plan & Product
Plan*	--Select-- 2/2 3/3 A
Product Redemption	1. Choose my Gold Product in future 2. Get Instant Product --Select--
Payment Info
Use my Virtual Gold E-Card
Charge my Gold Bank
Use following Gold E-Card

Gold E-Card No.
Gold E-Card Password

Charge following Gold Bank

Gold Account
GA-ID
Account Password
Security Question
Security Answer

Additional Payment Info

Payment by Value Card

Gold Value Card No.
Gold Value Card Password

Security Info
Password*	Re-type*
Secret Question*
Secret Answer*
Personal Info
Full Name	First* Middle Last*
Gender*	Male     Female
Mother's Name*	Re-type*
Date of Birth *	(d/m/yyyy)
National ID*
Contact Info
Address (Line 1)*
Address (Line 2)
State
Post Code
Phone*	Only digits (With country and city code)
Land Line/Phone2*	Only digits (With country and city code)
Email*	(This address can only be changed by requesting to admin by providing copy of Passport/ID Card)
Secondary Email	(Changeable by user)
Accept Terms & Conditions?   No   Yes