Application Form: Individual
1.
Name in Full:
2.
I.C. / Passport Number:
3.
Nationality:
4.
Designation:
5.
Company:
Company Particulars
a)
Company Type:
(Private/Public/Branch/Other)
b)
Business Type:
(Manufacturing/Trading/Service/Finance/Others)
c)
Is the company? (tick where appropriate)
Malaysian Company with investment in Australia
Australian Company with investment in Malaysia
Subsidiary/Branch of an Australian Company
A Malaysian/Australian partnership, joint venture company
A company trading with both Malaysia and Australia
An overseas multinational
(ie non Malaysian and non Australian)
Local (Malaysian) company/partnership/sole proprietor
Other, please specify:
6.
Address (tick preferred correspondence address)
Company Address
Suburb:
Postcode/Zip:
Telephone:
Fax:
Email:
Handphone:
Home Address
Suburb:
Postcode/Zip:
Telephone:
Fax:
Email:
Handphone:
7.
Name of Spouse:
8.
Special Interests / Hobbies:
Proposer/Seconder
(where available or
skip
to submit the form)
Proposer
1.
Name:
2.
I.C. / Passport Number:
3.
Designation:
4.
Company:
5.
Address
Suburb:
Postcode/Zip:
Telephone:
Fax:
Email:
Handphone:
Seconder
1.
Name:
2.
I.C. / Passport Number:
3.
Designation:
4.
Company:
5.
Address:
Suburb:
Postcode/Zip:
Telephone:
Fax:
Email:
Handphone:
[
Introduction
] [
Committee
] [
Business
]
[
Membership
] [
News & Events
] [
Important Links
] [
Email
]
