Note : Fields marked with * is compulsary.
The Secretary General
Sarawak Dayak Graduates Association
Sir/Ms,
I wish to apply to be an ordinary/life* member of the Sarawak Dayak Graduates Association. My particulars are as follows.
Name:
*
Date of Birth:
*
[day]
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/ [month]
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/ [year]
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2011
2012
Place of Birth:
*
Sex:
*
Male
Female
Age(yrs):
Ethnic Group:
*
New Identity Card:
*
Old Identity Card:
Occupation:
*
Address of Longhouse/Kampung:
*
Education Attainment
[Please send/email photocopy(ies) of your certificate(s)]
*
Level
Qualification
Institution
Year
Diploma
Bachelor
Master
Doctorate
Professional
Others
Contact numbers and Email
House: *
Mobile:*
Office No:
Fax No:
Email:
Residential Address:
*
[Tick If Correspondence Address]
Office Address:
*
[Tick If Correspondence Address]
Membership Fee Info
:
Registration fees - RM 10.00
Annual Membership fees - RM 20.00
Life Membership fees - RM 200.00
Declaration
I declare that the information given above is true, and if accepted as a member, I will abide by the constitution, rules and regulation of the Society
Application Proposed by:
Application Seconded by:
I would like to contribute and play a role in the following areas
[please tick the box]
Education
Welfare
Sports
ICT
Religions/Spiritual
Cultural
Social
Legal
Economics/Finance
Research
Others (Specify Area)