Pop-Up Service Provider Registration

1. Service Provider Information

Company Name *

Company Type *

Corporate SME

SME Certificate Number

BRN/Trade License No. *

VAT Number

Contact Person *

Phone Number *

Email Address *

2. Nature of Products/Services

Description of Products/Services *

Will any electrical equipment be used? *

Yes No

Are food items involved? *

Yes No

Food Permit * Please attach your food permit (if food items are involved)

3. Pop-Up Duration

Start Date *

End Date *

Daily Operating Hours - From *

To *

4. Location Allocated (To be confirmed by Mall Management)

Zone/Area *

Stall No. / Space Reference *

Number of Chairs

5. Required Approvals

Public Liability Insurance *

Attached Not Applicable

Food/Health Permit (if applicable) *

Attached Not Applicable

Electrical Compliance (if applicable) *

Attached Not Applicable

Fire Safety Compliance *

Attached Not Applicable

Copy of BRN/ID *

Attached Not Applicable

6. Applicant Declaration

I declare that all information provided in this application is true and accurate. I understand that any false information may result in the rejection of this application or cancellation of the permit. I agree to comply with all terms and conditions set by La City Trianon management.

Applicant Signature *

Date *