KLSICCI MEMBERSHIP APPLICATION FORM

Membership Type Entrace Fees ( One ) Yearly Subscription
ORDINARY MEMBER
• FIRMS (Sole Proprietorship or Partnerships)
RM100
RM350
• LIMITED COMPANIES
RM100
RM500
ASSOCIATE MEMBERS
RM200
RM250
HONORARY MEMBERS
N/A
N/A
LIFE MEMBERS
N/A
RM5,000

MEMBERSHIP TYPES

COMPANY PROFILE

COMPANY NAME

COMPANY ADDRESS

MOBILE NUMBER

COMPANY REG. NO

EMAIL ADDRESS

WEBSITE

SOCIALS

BUSINESS SECTOR

NATURE OF BUSINESS


PERSONAL INFORMATION


REPRESENTATIVE

ALTERNATE

ADDRESS

ADDRESS

TEL NUMBER

TEL NUMBER





NRIC NO

NRIC NO



SEX

SEX

DATE OF BIRTH

DATE OF BIRTH

NATIONALITY

NATIONALITY

MEMBERSHIP TYPE