ALL fields are required to be completed. Please print clearly in English using BLOCK LETTERS and where appropriate.

If you are already an Enrich Member, please fill in your membership number: M H
Your Personal Details Title Mr Mrs Others (indicate below) Ms

Your Correspondence Details Address

City

State/Province Postal Code Country

Last Name/Surname (as shown in your passport)

Join the GRADS e-community First Name/Given Name (as shown in your passport) I hereby agree to receive communication via email. Your Agreement Nationality Passport No. I/C No. (if applicable) I hereby apply to become a Member of GRADS and agree to abide by the Terms & Conditions of Membership as published by Malaysia Airlines and as may be amended or supplemented from time to time. This agreement is not valid unless signed below.

Date of Birth (dd-mm-yyyy) Signature Date

Gender College

Male

Female

Please complete Section B if your Student ID/Matric card does not indicate month and year of study or whether you are a full-time student, or if you do not have an offer letter. Section B To be completed by the Principal/Registrar I, Principal/Registrar of the School/College/University of the applicant stated above, do herewith certify that the applicant is a full-time student and will remain so until (month) (year). (Date of completion of studies)
Area Code

Course

Year of Study

Your Contact Details Mobile

Country Code

Phone No.

Phone
Country Code Area Code

Authorised signature

Date

Phone No.

Email Address

Official stamp