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- Membership Application/Renewal
Please fill in the form below
to register online. All fields
are required.
Kindly
contact the Secretary if you do
not receive an e-mail acknowledgement
of your registration within 2
weeks. Thank you.
Title:
Name:
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Address / Institution:
Academic Qualification (Degree,
Institution, Field, Year):
Current Research Field:
Current Position:
Employer:
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Facsimile :
e-mail
address:
Amount
payable: RM
I
am applying to become a Member
/ Student Member / Life Member*
of the Malaysian Society for Biochemistry
and Molecular Biology. I agree
to abide by the Society’s Constitution
and Rules. Please find enclosed
a Cheque (No:
/ Draft (No.
/ Cash* payable to The Malaysian
Society for Biochemistry and Molecular
Biology for RM
.
Signature: ___________ Date: _______________
*
Delete where appropriate
_____________________________________________
For Society’s Use Only Membership
No:
_______________
Date
of Receipt: ___________Date of
Acceptance: ___________President’s
Endorsement:___________ Date:__________
Hon. Secretary’s Confirmation:____________
Date:_________________
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