Application for Junior Membership

Please upload your passport size photo here.*
Application for Junior Membership
Information for Junior Membership:
1. Applicants for Junior membership should be at the age of 16 and before 21 years old.
2. Proposers and seconders must themselves have been "active members" of the club for at least 6 months. Parents are not allowed to act as proposers or seconders. Please click the "Save" button below each time a proposer or seconder signs this application form to ensure all existing information is saved. This link is not shareable; the proposer or seconder must physically sign the form.
3. The monthly subscription fee is RM43.20 (RM40 +8% SST).
Payment Method either online payment or cheque, cash is not allowed.

RHB account: 20705500034722

4. All information provided in this application must be accurate and complete.

Junior Membership
- Junior member's passport size picture.
- Photocopy of the Junior member's birth certificate.
- Photocopy of the Junior member’s ID card (IC) or passport.
- Proof of full-time student status, such as a student ID or an acceptance letter from the educational institution or a no-objection letter from the head of the educational institution or school.
Junior Member Details:
Full Name*

PrefixFirst NameLast Name
Date of Birth*

DayMonthYear
Date
Nationality*
I/C No. or Passport No.*
Malaysia Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Name of School (Educational Institution)/ Name of Company (Employed)*
Occupation*
Student, Intern, Coordinator, Assistant...
Parent's Name (OTM Only)*

PrefixFirst NameLast Name
Phone Number*

Area CodePhone Number
Club Number*
X0000
Parent's Signature (OTM only)*

I have no objection to my child's application for Junior Membership.
Proposer and Seconder Section

Please click the "Save" button below each time a proposer or seconder signs this application form to ensure all existing information is saved. This link is not shareable; the proposer or seconder must physically sign the form.

Proposer and Seconder Details:*

Rows	Club Number	Prefix	Full Name	Acquaintance Duration (Years) (0,1,2....)	Acquaintance Duration (Months) (0,1,2...)
Proposer
Seconder

Proposer's Signature (OTM only)*
Seconder's Signature (OTM only)*
Junior member's passport size picture.Photocopy of the Junior member's birth certificate.Photocopy of the Junior member’s ID card (IC) or passport.Proof of full-time student status, such as a student ID or an acceptance letter from the educational institution or a no-objection letter from the head of the educational institution or school.
Downloadable Documents:

Optional:

-AUTO PAYMENT AUTHORIZATION FORM

We strongly encourage you to enroll in automatic debit payments. Please complete the form and upload it using the 'File Upload' feature below.

Click here to download the AUTO PAYMENT AUTHORIZATION FORM.
File Upload*

Junior member- Passport size picture, Birth certification, IC/Passport, Student ID, Acceptance Letter, Educational Institution no-objection letter.
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***If you are experiencing difficulties uploading documents, please submit the remaining documents to the reception or send them to us via email at info@penangswimmingclub.com
Declaration
I   First Name*   Last Name*   hereby declare that all information provided in this application is accurate and complete to the best of my knowledge. I understand and agree to abide by the rules and conditions set forth by the Penang Swimming Club for junior membership.

Signature*

Today's Date   Date*   .
Should be Empty:

Application for Junior Membership

Junior Member Details:

Proposer and Seconder Section

Declaration