PEREKA - Perekamuda Membership Registration

This is an online registration form for a new PEREKA membership.

Name

Example : Zainal Bin Muhamad

Status Keahlian

Gender

Male
Female

IC Number

Example : 000000-00-0000

IC Copy

please cross out the photocopy Maximum size 250KB. Acceptable File: jpeg, png, pdf)

Attach file

Drop files here

Phone Number

Example : 0123456789

Billing Address

Example : No 1, Jalan Sutera 1, Taman Sutera. 8200. Yong Peng. Johor

{name}

Currently studying

Which is related to Industrial design.

Doctoral Degree
Master's Degree
Bachelor's Degree
Diploma
Certificate

Portfolio website

your website, LinkedIn profile etc (if acquired)

Registration Fee - FREE

The payment of RM50.00 for the registration fee is waived for free, until further notice. There is no annual fee apply but this type of membership is only valid until finishes his/her studies. Payment can be made through Bank : Maybank Berhad Account Holder : Persatuan Pereka Perindustrian Malaysia Account Number: 5624 0563 9889 Attach your receipt and proof of payment. Maximum size 250KB. Acceptable File: jpeg, png, pdf)

Attach file

Drop files here

Acknowledgement

I hereby acknowledge that all information provided is true and the association reserves the right to reject or cancel my membership if it is found that there is false or untrue data. I hereby agree to be bound by the rules & constitution of the Association of Persatuan Perindustrian, Malaysia (PEREKA). PEREKA reserves the right to use members' personal data only for association matters. PEREKA will not provide personal data to any third party without the consent of the member.

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