easy2send
Registration Form

Sender Information

(For English & Khmer forms: Please fill out the form in English.)

Title

First Name

Last Name

Local Phone Number

Email Address

Occupation

Employee Government Worker Business Owner

If Other, please specify:

Workplace Name

Office Address

Date of Birth

Native Country

Passport ID

ID Validity Date

Issued by

ID Issued Country

Type of Residence

Apartment Hotel House

If Other, please specify:

Residential Address

Mailing Address

Same as Residential Address Other

If Other, please specify:

Entity Type

Individual Company

Receiver Information

(Please fill out the form in English.)

Title

First Name

Last Name

Receiver Mobile Number (with Country Code)

Receiver Email Address

Receiver ID or Passport Number

Receiver Country

Receiver Bank Name

If Other, please specify:

Receiver Account Number

Receiving Currency

Transfer Purpose

Personal Savings Education Family Expense Gift Travelling Other

If Other, please specify:

Relationship with Receiver

Self Family Friends Other

If Other, please specify:

Receiver Address

easy2sendRegistration Form

Sender Information (For English & Khmer forms: Please fill out the form in English.)

Receiver Information(Please fill out the form in English.)

easy2send
Registration Form

Sender Information

(For English & Khmer forms: Please fill out the form in English.)

Receiver Information

(Please fill out the form in English.)