Fields marked with * are mandatory
Title*
:
Mr.
Mrs.
Ms.
First Name*
:
Last Name (Surname)*
:
Gender*
:
Male
Female
Identification Type*
:
IC
Passport
NRIC/Passport No.*
:
Please present your NRIC/Passport No. when claiming your membership card
Place of Issue For NRIC/Passport No.*
:
AFGHANISTAN
ALBANIA
ALGERIA
ANGOLA
ARGENTINA
ARMENIA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHRAIN
BANGLADESH
BELGIUM
BELIZE
BHUTAN
BOLIVIA
BRAZIL
BRUNEI
BULGARIA
CAMBODIA
CAMERON
CANADA
CHILE
CHINA
COLOMBIA
COSTA RICA
CROATIA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
EGYPT
FINLAND
FRANCE
GABON
GEORGIA
GERMANY
GHANA
GREECE
GREENLAND
GUAM
GUYANA
HONDURAS
HONG KONG SAR
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND
ITALY
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KUWAIT
KYRGYZSTAN
LAOS
LEBANON
LIBYA
LUXEMBOURG
MACAU SAR
MADAGASCAR
MALAYSIA
MALDIVES
MALTA
MARSHALL ISLAND
MAURITIUS
MEXICO
MONACO
MONGOLIA
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW ZEALAND
NIGERIA
NORWAY
OMAN
PAKISTAN
PANAMA
PAPUA N.GUINEA
PERU
PHILIPPINES
POLAND
PORTUGAL
PUERTO RICO
QATAR
RUSSIA
SAMOA WEST
SAUDI ARABIA
SIERRA LEONE
SINGAPORE
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SRI LANKA
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TANZANIA
THAILAND
TONGA
TURKEY
U.ARAB EMIRATES
UKRAINE
UNITED KINGDOM
UNITED STATES
UZBEKISTAN
VENEZUELA
VIETNAM
YEMEN
ZIMBABWE
Date of Birth*
:
January
February
March
April
May
June
July
August
September
October
November
December
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
Residential Address*
:
City*
:
State*
:
JOHOR
KEDAH
KELANTAN
MELAKA
NEGERI SEMBILAN
PAHANG
PERAK
PERLIS
PULAU PINANG
SABAH
SARAWAK
SELANGOR
TERENGGANU
W.PERSEKUTUAN
Country*
:
AFGHANISTAN
ALBANIA
ALGERIA
ANGOLA
ARGENTINA
ARMENIA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHRAIN
BANGLADESH
BELGIUM
BELIZE
BHUTAN
BOLIVIA
BRAZIL
BRUNEI
BULGARIA
CAMBODIA
CAMERON
CANADA
CHILE
CHINA
COLOMBIA
COSTA RICA
CROATIA
CYPRUS
CZECH REPUBLIC
DENMARK
DOMINICA
EGYPT
FINLAND
FRANCE
GABON
GEORGIA
GERMANY
GHANA
GREECE
GREENLAND
GUAM
GUYANA
HONDURAS
HONG KONG SAR
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND
ITALY
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KUWAIT
KYRGYZSTAN
LAOS
LEBANON
LIBYA
LUXEMBOURG
MACAU SAR
MADAGASCAR
MALAYSIA
MALDIVES
MALTA
MARSHALL ISLAND
MAURITIUS
MEXICO
MONACO
MONGOLIA
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW ZEALAND
NIGERIA
NORWAY
OMAN
PAKISTAN
PANAMA
PAPUA N.GUINEA
PERU
PHILIPPINES
POLAND
PORTUGAL
PUERTO RICO
QATAR
RUSSIA
SAMOA WEST
SAUDI ARABIA
SIERRA LEONE
SINGAPORE
SOMALIA
SOUTH AFRICA
SOUTH KOREA
SPAIN
SRI LANKA
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TANZANIA
THAILAND
TONGA
TURKEY
U.ARAB EMIRATES
UKRAINE
UNITED KINGDOM
UNITED STATES
UZBEKISTAN
VENEZUELA
VIETNAM
YEMEN
ZIMBABWE
Postcode Code
:
Email Address*
:
Contact Number*
:
+6010
+6011
+6012
+6013
+6014
+6016
+6017
+6018
+6019
+602(Singapore)
International
Security Codes
:
Enter the text you see above:
I have carefully read and understood the attached
Terms & Conditions
and agree to abide by the same as amended and any amendments thereafter
on approval of this membership application.