Student Membership

* Full Name:

* Residential Address:

* Contact Number:

* Date of Birth:

* Gender:

* Race:

* State of Origin:

* Malaysia ID Type:

* Malaysia ID Number:

* Singapore ID Type:

Singapore ID Number:

* Name of School / Institution:

Referred by:

* Email Address:

Screen Name:

* Password (> 6 characters long)

* Password Confirm

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Interests (you may chose more than one): Culture & the Arts Entertainment Family Outings Food Events Malaysian Festivals Networking Sports Travel & Tourism

Terms of Membership:

By filling in and submitting this membership application form, I agree that MASIS may collect, use, and disclose my personal data, as provided in this application form, or (if applicable) obtained by the MASIS as a result of my membership, which is necessary to accurately establish my identity to a high degree of fidelity for the processing of this membership application, the administration of my membership, and the dissemination of marketing materials (from MASIS or its third party partners) that I have agreed to receive, all in accordance with Singapore Personal Data Protection Act 2012 and MASIS Privacy Policy
I warrant that all the information provided herein is true and accurate to the best of my information and knowledge.
I hereby undertake to abide by all the rules and regulations of MASIS.

I consent to the terms above. (Please check box)

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