Associate Membership

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* Full Name:

* Residential Address:

* Contact Number:

* Date of Birth:

* Gender:

* Malaysia ID Type:

Malaysia ID No.:

* Singapore ID Type:

Singapore ID No.:

* Name of Company / Institution:

* Designation:

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* Password (> 6 characters long)

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Terms of Membership:

I, the above named Applicant, consent to the collection and use of my personal data to MASIS, and that I have also obtained the consent from all the other applicants named above (if any), for the purposes of registration, processing and administering of membership-related benefits and services.
I may opt out of sharing my information or limit the optional information by duly informing MASIS in writing.
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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