Submit Now

Segment*

Full name (As per NRIC/Passport) *

Gender *

NRIC or Passport no *

Mobile number *

Email *

Address *

Address 2

City *

State / Province *

Postal / Zip Code *

Receipt number *

Receipt date *

Upload receipt (choose file - allow for only 1 receipt, file type: .png/.jpg/.jpeg/.pdf, max size: 25MB) *

What is the tagline for this campaign? *

Fans Have More Friends Refreshing First Taste Refresh Your Music, Refresh Your Night

* I acknowledge that I have read and understood the Terms & Conditions, the Privacy Policy, and consent to the collection, use of data for the purposes set out therein.

* I confirm that the information and documents submitted in this form are accurate, correct and complete. I am aware that after submitting this form, I am unable to amend any of the details submitted.

I consent to receiving Heineken® Beer marketing and promotional message/email.

OTP sent to . Enter OTP *

Wrong number?
Re-enter here

THANK YOU

Your entry has been submitted! Submission ID [SubmissionId].

For any further clarifications about your contest submissions, please contact 014-5055420.

Submission Form

OTP Verification

Submitted

THANK YOU

Submission Form

OTP Verification

Submitted

THANK YOU

Confirmation

Exceed Maximum Phone Number In Segment