Borang Keahlian PRADAS
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Transcript of Borang Keahlian PRADAS
TERM & CONDITIONS1. Membership registration fee RM50, annual fee RM50 & card RM7.2. All payment must be payable in cash or MBB#562106221613. Please retain bank slip for proof.3. The committee reserves the right to approve/decline membership without giving any reasons.4. All registration form must be submitted to the PRADAS Secretary.
DETAILS OF MEMBER APPLICATION
Name (as NRIC):
Home Address:
Postcode: City:
State: Country:
E-Mail:
Gender: Male Female NRIC:
Date of Birth: Tel (House):D D M M Y Y Y Y
Occupation:
Department:
Office Address:
Postcode: City:
State: Country:
Tel (Off): Tel (H/P):
Preferred Callsign: P R Amateur Callsign:
ACKNOWLEDGEMENT
Introducer Name: Callsign: P R -
Alternate Contact Person (emergency cases):
Tel: Relation:
I/we agree to accept and be bound by Term & Conditions which accompany the member of PRADAS.These Term & Conditions may be subjected to change by PRADAS and I/we will be notified in a manner,as PRADAS deems appropriate. I/we confirm that the information given herein by me/us is true and correct.
Date:Signature of Applicant
FOR OFFICE USE ONLY
Date of received application:D D M M Y Y Y Y
Reference / Membership No.:
Approved: Not approved:
Date:Official Signature/Call Sign P R - WEB PRADAS borang ahli v3
please attach photo here
APPLICATION FORM
Persatuan Peminat Komunikasi Radio Dua-HalaSelangor (PRADAS)C-10A-07, Lestari Apartement,Jalan PJU10-1B, Damansara Damai,47830 Petaling Jaya, Selangor.Tel.: 016-2348227Web: www.pradas.org.my