Part I PERSONAL PARTICULARS

1
Please tick the relevant application
student member (2 years
membership) RM60
ordinary member RM 50 per annum there is an
entrance fee of RM 10 for new members
Part I - PERSONAL PARTICULARS 1. Full Name
(Mr./Mrs./Miss/Others) _____________________
__________________________________________________
__________________________________________________
2. NRIC No ___________________________
3. Citizenship ________________________ 4.
Date of Birth ________________________
5. Marital Status ______________________ 6.
Residential Address _______________________
____________________________________
__________________________________________________
__________________________________________________
____________________ 7. Business or Office
Address ______________________________________
_______________ ____________________________
__________________________________________________
8. Tel (res) ____________________________
___ Fax _____________________________
(off) _______________________________
Other ____________________________ Part 2
- CURRENT APPOINTMENT 2.1. Designation
__________________________________________________
______________ 2.2. Date Appointed
__________________________________________________
___________ 2.3. Name of Employer
__________________________________________________
________ 2.4. Address ______________________
_____________________________________________
_____________________________________________
_______________________________ 2.5. Nature of
Business _____________________________________
_____________________ Part 3 - EDUCATION
TRAINING RECORD (The highest qualification
attained)
SCHOOL/COLLEGES/ UNIVERSITIES
DATE FROM/TO
DURATION OF STUDIES
GRADES/DIPLOMA DEGREES OBTAINED









2
LIST OUT THE RELEVANT TRAINING SPECIALISED
PROFESSIONAL COURSES YOU HAVE UNDERGONE OR
SUCCESSFULLY COMPLETED
TYPE OF COURSE
INSTITUTION/ORGANIZER
DURATION
Part 4 - DECLARATION I hereby apply for
admission to the Rolls of Membership of the
Malaysian Association of Productivity MAP on
the grade as deemed appropriate by the Council.
I undertake to abide by the Constitution and
will comply with the by-laws, rules and policies
of MAP during the currency of my
membership. I declare that all particulars
and information as have been supplied in
connection with this Application are true and
correct to the best of my knowledge and belief.
If any of the above is found to be untrue,
MAP reserves the right to act
accordingly. Date ____________________
Singature of Applicant _________________________
______ ------------------------------------------
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---------------------------
FOR OFFICIAL USE
Council / President Approval Yes/No
_________________________________________ Reason
_______________________________________________
_______________________
__________________________________________________
____________________ Records Registration
______________________________________ Date
______________________________________ F
ile No _________________________________
_____ Date ________________________
______________