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Member Registration Form

First Name

Last Name

Gender

Email

Date of Birth

Nationality

IC or Passport Number

Address

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City

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Type of Membership

Lifetime (MYR 1000)

Ordinary (MYR 100 per year)

International (USD 30 per year)

Reason to become WAIM Member

I declare that the information supplied in support of my application for membership is to the best of my knowledge, true and correct.

Membership Application