Membership – The Indian Graduates Association of Universiti Putra Malaysia

Employment Details

Employment EmployedEntrepreneur

Position

Nature of Employment

Current Employer/Company

Phone No

Fax No

Email Address

Company Website

Professional Experience

Highest Qualification obtained from UPM

* Please attach a copy your certificate (Academic or/and Professional qualification)

Period of Study

to

Residence College

Faculty

Referral Contact (Please 2 potential IGAUPM members)

Name (required)

Home Phone No

Office Phone No

HP No

Email Address

Name (required)

Home Phone No

Office Phone No

HP No

Email Address

Application Details

I wish to apply for *normal / life / associate membership in the Indian Graduates Association of UPM.

NormalLifeAssociate

I hereby enclose *RM50.00/250.00 being the registration and first year subscription fees. *Registration fee (for new members only): RM 25.00 + Annual subscription: RM 25.00. Onetime fee for life time membership: RM 250.00

Payment Method: (please ‘tick’ it)

CashChequeMoney / Bank OrderBank Deposit

For the Bank Deposits, please deposit into “Persatuan Graduan India Universiti Putra”. CIMB Bank Account No. 8002-15-8893.

The bank-in slip must then be emailed to: igaupm_secretariat@hotmail.com

All cheques and money/bank order should be crossed and made out in favour of “Persatuan Graduan India Universiti Putra” and addressed to:

PERSATUAN GRADUAN INDIA UNIVERSITI PUTRA MALAYSIA
Indian Graduates Association
Universiti Putra Malaysia
Jabatan Sains Tanaman,
Fakulti Pertanian,
Universiti Putra Malaysia,
43400 UPM Serdang,
Selangor, Malaysia.
(Attn: Assoc. Prof. Dr. Uma Rani Sinniah)

Your Name (required)
Date of Birth (YYYY-MM-DD)	Gender MaleFemale	IC No
Residential Address
City		State	Postal Code
Home No	HP No	Email Address
Facebook	Linkedin	Alternative Email Address

Online Membership Application Form