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PPS Membership Registration Form
Annual Membership (Approved Membership and Membership No. will be updated via Watsapp)
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Email
*
Your email
FULL NAME:
*
Your answer
DATE OF BIRTH:
*
MM
/
DD
/
YYYY
GENDER:
*
Male
Female
Other:
IC NO:
*
Your answer
TEL. NO:
*
Your answer
RESIDENCE ADDRESS:
*
Your answer
CITY:
*
Your answer
STATE:
*
Your answer
POSTCODE:
*
Your answer
MEMBERSHIP TYPE:
*
Payment for Premium Membership can be made monthly.
Basic (RM25.00 only)
Life Time (RM500.00 only)
MODE OF PAYMENT:
*
Cash
Bank Transfer: Persatuan Kebajikan Tatwamasi Seremban (CIMB Bank 8009943227)
TERMS AND CONDITIONS:
*
I understand that membership fees are non-refundable.
Yes
No
I agree to abide by the rules and regulations of the organization.
I understand that membership fees are non-refundable.
Would you like to subscribe to our free newsletter?
Yes
No
I agree to abide by the rules and regulations of the organization.
I understand that membership fees are non-refundable.
Would you like to subscribe to our free newsletter?
A copy of your responses will be emailed to the address you provided.
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