PSS Membership Registration Form

PSS Membership Registration

Complete the form below to sign up for our membership service.
Category: Please tick ( √ ) on the applicable
Title: Please tick ( √ ) on the applicable

Other
- Full Name
  
  First NameLast Name
- Identification Card No:
- Address:
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- E-mail
  example@example.com
- Mobile Phone Number:
  
  Area CodePhone Number
- Company Name
- Position
- Company Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Membership Rules
- 1.0 Membership Criteria:
  - Citizenship: Malaysia
  - Age Limit: 18 years of age or older
  - Residence: Selangor
  - Races: All
  - Gender: All
  - Religions: All
  - Other criteria: No Bankruptcy, No Criminal Record
  Every application to become a member must be proposed and supported by a member and sent to the Secretary who is required to submit the application as soon as possible to the Committee for consideration. The Committee may at its discretion reject any application without giving a reason.
- 2.0 Membership Fees:
  
  Member of Pertubuhan Suara Selangor shall pay membership fee for:
  - Registration Fee: RM10
  - Annual Membership Fee: RM10; or
  - Lifetime Membership Fee: RM50
- Where did you hear about us?
  
  Other
- Privacy Policy
- Please reach out and read our Privacy Policy in order to understand how your information is used and shared, and check below if you accept the policy.
- I declare that all the statements given above are true. I am aware that the Pertubuhan Suara Selangor has the right to reject this application if it finds at any time that the information provided is not true.
  
  Saya mengaku bahawa segala kenyataan yang diberikan di atas adalah benar. Saya sedar bahawa pihak PERTUBUHAN SUARA SELANGOR mempunyai hak untuk menolak permohonan ini jika mendapati pada bila-bila masa keterangan yang diberikan adalah tidak benar.
- Signature
- Date
  
  MonthDayYear
  Date
- Once you submit your application, we will contact you shortly to complete your membership application. Thank you!
- Should be Empty:

PSS Membership Registration

Membership Rules

Privacy Policy