Application for Associate Membership

Please upload your passport size photo here.*
Application for Associate Membership
Information for Associate Membership:

An applicant for membership as an Associate Member must be proposed and seconded by an Ordinary Member or Ordinary Transferable Member. Associate Members are not permitted to propose or second applicants for membership.

Proposers and seconders must themselves have been members of the club for at least 6 months at the time they sign this application form, and they must have no reason to believe that they will cease to be members before the applicant is elected.

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.

Election proceedings take between one and three months.

Once the form is completed, it should be sent to the Club Secretary, who will subsequently present it to the Election Committee for consideration.

Conditions for Applying for Associate Membership:
1. The monthly subscription fee is RM69.12 (RM64 +8% SST). Registration fee is RM100.00
2. All information provided in this application must be accurate and complete.
Associate Membership
- Associate member's passport size picture.
- Photocopy of the Associate member's marriage certificate.
- Photocopy of the Associate member’s ID card (IC) or passport.
Associate 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 Company*
If none, just add "-"
Occupation*
Housewife, Sales Director, Pensioned (Sector), Manager...
Spouse's Name (OTM Only)*

PrefixFirst NameLast Name
Club Number*
X0000
Date of Marriage*

DayMonthYear
Date
Spouse's Signature (OTM Only)*

I have no objection to my spouse's application for Associate 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)*
General Questions
NoYes
If you select "Yes," please provide the reason and details.
Associate member's passport size picture.Photocopy of the Associate member's marriage certificate.Photocopy of the Associate member’s ID card (IC) or passport.
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*

Associate member- Passport size picture, Marriage certification, IC/Passport.
Cancelof
***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 associate membership.

Signature*

Today's Date   Date*   .
Should be Empty:

Application for Associate Membership

Associate Member Details:

Proposer and Seconder Section

General Questions

Declaration