PART 1: Your Personal Details

Note: After sending your Payment, please fill-up
the form below with accurate information.

Your Complete Name
(Your First and Last Name)

Your Email Address
(Submit a Unique, Valid and Active Email Address)

Your Cellphone Number
(Submit a Unique, Valid and Active Cellphone Number)

PART 2: Proof of Payment

Note: For us to verify your Payment for the Premium Upgrade Fee. You need to submit your Proof of Payment below.

Payment Method Used
Banco De OroBPI Cash DepositBPI Mobile TransferClixsense BalanceGlobe GCashLBC Pera PadalaMetrobankPalawan Express Pera PadalaSmart Padala or Smart MoneyUnionbank Cash DepositUnionbank Eon Cyber AccountWestern Union

Submit your Proof of Payment here
*we accept photo of receipt, deposit slip or screenshot of payment
*it must be clear and readable
*click "Choose File" button below to upload your proof of payment

*or you can simply enter your payment verification details below
*see sample payment verification details here

PART 3: Clixsense Account Verification Details

Note: For us to Upgrade your Clixsense Account. We need to verify and access your Clixsense account. It is required that you submit to us your Clixsense Account Access Codes.

For security reasons, you may temporarily change your password and other private details before you submit the form to us. You may change it back after we have upgraded your account.

Warning! Please provide the correct access codes below and DO NOT access your Clixsense Account while we are processing your Upgrade. This is to avoid errors and further delay on your Clixsense Account processing.

Your Clixsense Account Username

Your Clixsense Account Password

Note: Please review ALL the details you have provided above before clicking the Submit Button. Once you clicked the Submit Button, the details and information you have provided above will be considered Final and Unchangeable. Thank you and Welcome to the Team again!

Image Verification
(Write the image seen below at the space provided)

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