Member Registration for Associate Member - Step 1

Please fill in your personal particulars and the Proposer's membership no.


 
Personal Particulars
Full Name:
 
Preferred Name:
Permanent Address:
Postcode:
State:
if others, please state:
Country:
Postal Address: Tick to use permanent address
Postcode:
State:
if others, please state:
Country:
Gender:
Race:
Nationality:
I.C No / Passport No:
I.C No for Malaysian
Passport No for Non Malaysian
Your Photo:
(Passport Size)
Place of Birth:
Date of Birth:
Office Phone No:
Handphone No / Mobile No:
House Phone No:
Fax No:
Overseas Phone No:
(if any except Singapore)

[please include international country code and, city code followed by number]
Please use only numerics
Email Address
(Personal):
Email Address
(Office):
Current Position
Name of firm/Employer:
Address:
Postcode:
State:
if others, please state:
Country:
Title of position:
Date of Appointment:
v
Proposer's Details
Only active members (MIEM/FIEM) are eligible to serve as proposer and/or seconder.
Proposer's Membership No:
 

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