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| Name: |
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| E-mail: |
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| E-mail: |
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| Password: |
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| Verify Password: |
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| Membership Category(Tick the appropriate box) * |
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| SECTION A – MEMBER PROFILE |
| Name |  |
| Company name |  |
| Address |  |
| Tel No |  |
| Fax |  |
| Website / E-mail |  |
| Type of industry |
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| Job Title |  |
| Type of license |
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| SECTION B – PERSONAL PROFILE |
| Citizenship |
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| Date of birth |  |
| Sex |
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| Contact number |  |
| Spouse name |  |
| Interest |
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| NOTE* |
CORPORATE MEMBER (up to 3 representatives) ORDINARY MEMBER (Malaysia citizen only) REGISTRATION FEE (for new member only) - USD 10.00 MEMBERS JOINING AFTER 31st JANUARY,SUBSCRIPTION FEE WILL BE CALCULATED ON A PRORATA BASIS |
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