Membership Application Form
SECTION 1: Applicant's Details
Name
Email
Category
Select a category
Government/GLC
Private
Self Employed
Type of Savings
Select a type of savings
Membership
Special Savings
Shares
NRIC (New)
NRIC (Old)
Uniform
HP No.
Office No.
House Tel. No.
Emergency Contact
Maritial Status
Address
Occupation
Company Name
Company Address
SECTION 2: Applicant's Beneficiary
Beneficiary 1
Beneficiary Name
Beneficiary NRIC
Beneficiary HP Number
Beneficiary Relationship
Beneficiary Percentage
%
+ ADD BENEFICIARY
- REMOVE BENEFICIARY
SECTION 3: Applicant's Payment Information
Deduction Method
Select a type of savings
Employer
Auto Debit
Biro ANgkasa
Cheque
Online Transfer
Monthly Contribution
RM
Share
RM
Special Savings Amount
RM
Bank Account Number
Bank Card Number
Card Expiry Date
SECTION 4: Pengakuan & Akad
Dengan ini saya berikrar dan mengaku bahawa saya...
Sekiranya...
Saya bukan...
Saya tidak pernah...
Saya bersetuju...
Saya mengaku...
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