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Friends of Malaysia (FoM)Membership Form
This form is designed for Malaysia RPCVs, family members or loved ones of deceased RPCVs, and other friends of Peace Corps Malaysia. Please skip questions that are not applicable to your situation.
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Email
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Your email
1. Last Name (surname) of the person who is completing this form. If you had different name (e.g.) at the time of Peace Corps service, please write both, for example,
Knight Hirschman.
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Your answer
2. First Name (personal or given name). Please include all those that you generally use, for example, John Fitzgerald "Jack"
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Your answer
3. If you are joining FoM as a family member or friend of a
deceased Malaysia PCV, please write her or his complete name and date of death. Answer subsequent questions about your loved one but write your own name as the FoM member in the preceding questions.
Your answer
4. If you want to join FoM for another reason (not as RPCV or RPCV family member), please give a brief account of your connection to the Peace Corps or Malaysia. For example, a former student of a PCV.
Your answer
5. Have you ever been a member of Friends of Malaysia (FoM)?
New FoM member
Current or Past FoM member
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6. Preferred mailing address.
Your answer
7. Preferred phone number
Your answer
8. When (year) did you begin your Peace Corps service?
Your answer
9. When (year) did you complete your Peace Corps service?
Your answer
10. What was your training group number?
Your answer
11. What was your job assignment?
Your answer
12. Where (town and state) did you serve in Malaysia?
Your answer
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