Joining as Members

Name:
NRIC No:
Gender:		Age:
Occupation:
Mailing Address:
Contact No	House/Office:
	Mobile No:
Email	Personal:
	Official:
Academic Qualification (Highest):
	Awarded by
Professional Qualification:
	Awarded by
* Please attach a copy your certificate (Academic or/and Professional qualification) by email or fax (Attention : Dr. Rajesh Ramasamy).
List community-based programs (if any) which you have organised or participated in over the past five (5) years?
What is your motivation for joining TheMind?
How can you contribute to TheMind?
Terms and Conditions: Membership shall be opened to Malaysian Indians who meet ALL of the following criteria: (i) Above 18 years of age (ii) Malaysian citizen (iii) Awarded a degree by institution of higher learning in Malaysia or outside Malaysia which is recognised by The Government of Malaysia on the date of application OR a professional qualification that is equivalent to a degree Membership fee includes the following: (a) Registration Fee - RM 10.00 (b) Annual Subscription - RM 10.00 Payment Method Bank-in the exact amount (not more) Account Name: The Malaysian Indian Educational Development Association Account No: 12480008787056 (CIMB) Proof of Payment 1. Please email the scanned copy of bank-in slip to secretary@themindassociation.org OR 2. Fax the bank-in slip to 03-8947 2695 (Attention: Dr. Rajesh Ramasamy) Your membership status will be confirmed upon approval by the Management Committee and receipt of proof of payment. Note: For members with professional qualification, your membership number will be assigned immediately upon ROS approval. I agree with terms and conditions and would like to join as a member of The Malaysian Indian Educational Development Association (TheMind). (You must check the checkbox to continue your application.)