Membership Info Update – GBS Malaysia

GBS Malaysia Membership Info Update

EMAIL *

SUBSCRIPTION YEAR

Joined Year

IC NUMBER *

Without Dashes

SALUTATION *

MR.
MRS.
MISS

OTHER

FULL NAME *

As per IC - All Capital Letters

CITIZENSHIP *

MALAYSIAN

GENDER *

MALE
FEMALE

RELIGION *

HINDU

DATE OF BIRTH *

PLACE OF BIRTH *

City, State

OCCUPATION

SECTOR *

GOVERNMENT
PRIVATE
RETIRED
UNEMPLOYED

POSITION *

NAME OF EMPLOYER *

CONTACT INFORMATION

RESIDENTIAL ADDRESS *

CITY *

POSTCODE *

STATE *

DISTRICT *

MOBILE NUMBER *

Example: 019-5551212

HOME TELEPHONE NUMBER

Example: 03-98765432

IC COLOUR COPY ATTACHMENT

Kindly attach and upload your IC photocopy here. Requirement: 1. Colour photocopy (front and back) 2. Draw a double line on the top left corner of the IC copy with the wording “FOR OFFICE USE ONLY” (front and back)

IC Image Upload *

Drop your file here or click here to upload You can upload up to 1 files.

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