MyAIRA Membership Application Form

2024 MyAIRA Membership Application

I/We hereby apply to become an Individual Member/Company Member/State Association Member/Associate Member of the Malaysian Autonomous Intelligence & Robotics Association (MyAIRA) and if accepted, agree to be bound by the Constitution of MyAIRA for the time being in force
Date of Application

MonthDayYear
Date
Name*

PrefixFirst NameLast Name
Gender

MaleFemale
IC or Passport Number*
TYPES OF MEMBERSHIP
Membership Type

Ordinary Member (Entrance Fee RM100 + Annual Subscription RM280)Associate Member (Entrance Fee RM100 + Annual Subscription Fee RM280)Youth Member (Entrance Fee RM50 + Annual Subscription Fee RM50)Corporate Member (Entrance Fee RM100 + Annual Subscription RM500)
Company Information for Corporate Members Application
Official Member Nominee Name
Designation
Company Name
Type of Business
Company Registration No.:
Company Website.:
Company Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Member Applicant's E-mail
Company Director's Name
Company Director's Email
Company Phone

Area CodePhone Number
Personal Contact Information for Individual Member Application
By providing your email address you will be automatically subscribed to receive the majority of our communications via e-mail. An email address is required for accessing MyAIRA online services including dues payment, listing updates, or event/workshop registrations. We request personal information to keep you informed of events you may wish to participate in, knowing your office managers frequently discard bulk mail. The information you provide in the "personal contact information" section will not be released to any person or entity. However, some events require us to share registration information to sponsors for appropriate follow-up under limited circumstances.
Applicant Residential Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mobile Phone (+6012 -XXXXXXXX)

Country and Area CodePhone Number
Personal Email
example@example.com
Occupation
Employer (Name of Company)
Subject Matter of Expertise
Highest Education Level
Name of Education Institution
Name of Introducer*
I agree to conduct myself professionally and personally and to be governed by the Constitutions and By-Laws of the Malaysian Autonomous Intelligence and Robotics Association
Signature

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E-Signature Name*
Date*

MonthDayYear
Date
Which email do you prefer MyAIRA sends communications to? (Including MyAIRA newsletters and event info)*

office emailpersonal email
CORPORATE MEMBERSHIP STATISTICS (Must be completed)
1. Number of full time employees

10 employees and below11-20 employees21-50 employees51 employees & above
2. Type of company

Sole ProprietorshipPartnershipPrivate Limited CompanyPublic Listed CompanyJoint VentureOther
3. Paid-up capital

RM50,000 & belowRM50,001 - RM100,000RM100,001 - RM500,000RM500,001 - RM1,000,000RM1,000,001 - RM5,000,000Above RM5,000,000
4. Annual turnover

RM1,000,000 and belowRM1,000,001 - RM5,000,000RM5,000,001 - RM10,000,000RM10,000,001 - RM20,000,000RM20,000,001 - RM50,000,000Above RM50,000,000
Year of Incorporation:
Products and Services:
After submitting your application form, kindly send the following to treasurer@myaira.org and secretary@myaira.org

1) Proof of Payment

Malaysian Autonomous Intelligence & Robotics Association
Maybank : 5686 0302 8508

2) For Corporate Member Applications, please include your company's SSM documents

You will receive a confirmation email once your payment is received and application approved by the committee within 14 working days.
For Office Use Only

Proposed and seconded by an existing MyAIRA member:
Proposer
Seconder
Approved by MyAIRA Council Meeting held on:
New Membership No.:
President's/Honorary Secretary's Signature

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2024 MyAIRA Membership Application

CORPORATE MEMBERSHIP STATISTICS (Must be completed)

For Office Use Only