IAPMD MEMBERSHIP SUBSCRIPTION & RENEWAL FORM
Email *
YEAR OF RENEWAL *
NAME *
IDENTITY CARD/PASSPORT NO *
CURRENT WORKING ADDRESS *
PHONE NUMBER
MEMBERSHIP
Please tick one of the boxes below. Payment can be made by: 1. Banking in/transfer to a Maybank Ac no: 553131004310, registered under "PER AKADEMI PATOLOGI A'BANGSA M'SIA". Please email the receipt of the payment to IAPMD seceretariat; iapmdmembership@gmail.com OR 2. By cheque:Please make the cheque to: "PER AKADEMI PATOLOGI A'BANGSA M'SIA" and kindly email your evidence of payment.
Annual membership renewal fee *
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