Request for KHQR Form Shop Information Shop Name* Business Activity* Shop Contact Number* Shop Full Address* Province/City* -Province/Capital- Branch* -Select Branch- Payment Facilitative KHQR Standee KHQR Poster KHQR Sticker POS Machine Account Information Have you own account with KB PRASAC already? YesNo Account Number USD Account Number KHR Contact Information Contact Full Name Contact Position Contact Phone Number Attach Document
