REGISTRATION FORM. MEMBERSHIP NO: ____ BUDDHIST MISSIONARY SOCIETY MALAYSIA WELFARE SECTION Hon Secretary Buddhist Missionary Society Malaysia Welfare Section 123 Jalan Berhala Off Jin Tun Sambanthan 0470 Kuala Lumpur Dear Sir/Madam, 1 wish to enrol as a member of the BUDDHIST MISSIONARY SOCIETY MALAYSIA WELFARE SECTION and hereby abide by the rules and regulations, and any additions or amendments thereof which may be introduced from time to time NAME (BLOCK LETTERS - MDM/MS/MR) DATE OF BIRTH: SEX NRIC NO: (OLD) (NEW), _ OCCUPATION: NATIONALITY: PERMANENT ADDRESS, POSTCODE: ‘TELEPHONE NO.: (H) © (MOBILE) A FAX NO: PRESENT ADDRESS: POSTCODE: YOURS IN THE DHAMMA SIGNATURE OF APPLICANT PROPOSED BY. SIGNATURE, SECONDED BY, SIGNATURE NOTE: The applicant must.be a member of the Parent Body, Buddhist Missionary Society Malaysia, before applying to be a member of this Section. Please provide the membership number of the BMSM below:- MY BMSM MEMBERSHIP NO. IS