OT-Malaysia Members Registration Form.
I wish to apply for membership of the Persatuan Jurupulih Carakerja Malaysia, and hereby agree to abide by the provisions of the constitutions and all amendments thereof and all decisions of the duly elected committee.
Membership Fees (per annum) *
Life Member  RM350.00For Malaysian OT
Associate Member  RM20.00For Non Malaysian OT
Ordinary Member  RM30.00For Malaysian OT
Student Member  RM10.00For OT Student
WFOT Member  RM60.00For WFOT
Name *
NRIC *
Date of Birth dd/mm/yyyy
Citizenship * Malaysian Non Malaysian
Address Line 1
Address Line 2
City
State
Country
Postcode
Tel. No. *
Mobile
Email *
Picture
Qualification
Place of Training
Employer Detail (Current)
Address Line 1
Address Line 2
City
State
Postcode
Country
Tel. No.
Fax
Optional Email
Special Interest
 

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