|
NEW MEMBERSHIP REGISTRATION
Category
Fee
Children
2.00
Student
2.00
Adult
5.00
Senior Citizen
2.00
Foreigner
20.00
Disabled Person
Free
Please fill in all details
Name :
Date of Birth :
No IC/Passport No :
Patron Categories :
Public
MPSepang Staff
Council Member
Gender :
Male
Female
Race :
M - MALAY
C - CHINESE
I - INDIAN
O - OTHERS
Citizen :
MALAYSIAN
OTHERS
Occupation :
Email :
Address :
Mobile Number :
Tick if sign up for kids under 12 years old
Parents/Guardian Information (For Kids Membership below 12 Years Old Only)
Parent/Guardian's Name :
Email :
Mobile Number :
No IC/Passport No :
Purpose :