You are on page 1of 1

Member Serial Number

P.O. Box 12044, 50766 Kuala Lumpur, West Malaysia. www.psm1956.org

MEMBERSHIP APPLICATION FORM

To: The Secretary The Photographic Society Of Malaysia P.O. Box 12044, 50766 Kuala Lumpur.
Dear Sir, I am interested to be a Member of the Society. I hereby agree to abide by its rules and regulations. I enclose herewith two photographs 2" X 1.5" for application of membership use.

Photo

2 x 1.5 RM50.00 x 2 = RM100.00 + RM200.00 = RM300.00 RM800.00 + RM200.00 = RM1,000.00


Ordinary Member Annual Subscription RM50.00 x 2 years = RM100 + Entrance Fee RM200.00 = RM300.00 Life Member fee RM800.00 + Entrance Fee RM200.00 = RM1,000.00

USD300.00 + USD30.00 = USD330.00

Oversea Life Member fee USD300.00 + Entrance Fee USD30.00 = USD330.00Except Singaporean

: 50 RM400.00 RM50.00 = RM450.00

Senior Life Membership: Those who are above the age 50 shall pay the Membership of RM400.00, Entrance fee RM50.00 = RM450.00

News Letter Life Member

Ordinary Member

Name

Senior MShip (Life Member Only)

English

Chinese

Chinese Name

New Date of Birth

I/C No.

D D MMY Y

Nationality

Sex

Male

Female

Occupation

Honours

Education

Address

Website

Tel. No. : Post Code H/P No. : Fax Email

State

Country

I am member of other photographic society (Please state below)

Date Application Submitted

Introducer

Tel. or H/P No.

Applicants Signature

Please completed all the detail with block letters.

For Committee Use For Secretary

For Treasurer

Remark

Date Approved

Cash Bank SECRETARY

Receipt No.:

Cheque No.: PRESIDENT

You might also like