MCHAM MEMBERSHIP APPLICATION FORM

Personal Details
Full Name (as per NRIC)*

PrefixFirst NameLast Name
Phone Number*

Country CodeArea CodePhone Number
E-mail Address*
NRIC/Passport Number*
Example: 690304-04-1487
Date of Birth*

DayMonthYear
DD-MM-YYYY
Occupation*
Nationality*
e.g. Malaysian
Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
How did you hear about us?*
If others, please specify

Family Details
Father's Name*
Father's Ethnicity*
Father's Membership Number (if applicable)
Mother's Name*
Mother's Ethnicity*
Mother's Membership Number (if applicable)
If your parents are not Melaka Chettis, how are you connected to the community?*

Contribution to the Association
Would you be willing to be a volunteer or part of the working team?*
If yes, in which are are you willing to help?*

Membership Details

Your membership fee will be paid together with a one-time registration of RM10. Once your membership application is approved, you will be contacted to complete the payment.

Ordinary member	RM100 + RM10	Available to Malaysian citizens who are over 18 years old and currently residing in Malaysia.
Associate member	RM100 + RM10	Available to individuals who do not meet the criteria for ordinary membership.
Life member	RM1,000 + RM10	Available to regular members who have maintained their membership for at least 5 years.

Membership Preference*
I declare that the information provided is accurate, and I agree to abide by the Association’s rules and by-laws, including any additions or alterations that may be introduced from time to time.
Signature*

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