Harvard Club of Malaysia (HCM) Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in joining the Harvard Club of Malaysia (HCM). We require you to complete this form and pay the fees before we can confirm your membership. Details are available below.

Kindly read the Harvard Club Constitution to familiarize yourself with the requirements and conduct of becoming a member of the Harvard Club of Malaysia. https://drive.google.com/file/d/1GEwYuFlB6_xifqbc-Zse6X-n467Q1i8W/view?usp=sharing

Form updated: 21 June 2024

First Name *

Last Name *

Phone number (format: +6012 345 6789) *

Email Address
*

Designation *

Organization/Company *

Office Address

Home Address

Harvard School or Department
*

Harvard College

Harvard Kennedy School

Harvard Business School

Harvard Law School

Harvard Divinity School

Harvard Medical School

Harvard Graduate School of Design

Harvard Graduate School of Education

Harvard Graduate School of Arts and Sciences

Harvard Faculty of Arts and Sciences

Harvard John A. Paulson School of Engineering and Applied Sciences

Harvard School of Dental Medicine

Harvard T.H. Chan School of Public Health

Harvard Division of Continuing Education

Radcliffe Institude for Advances Study

Other:

Required

Programme

Graduation Year

Harvard Graduation ID

HCM Membership Category and Fee *

Alumni (Harvard Program with Harvard Key) at RM200 lifetime fee

Harvard Student RM 200 lifetime fee

Associate (Harvard Program without Harvard Key) at RM300 lifetime fee

Friends of Harvard Club of Malaysia (Friends and Family of Alumni) at RM300 lifetime fee

In order to accept and confirm your membership application, the fee above must be paid to HCM account, and proof of payment must be sent to HCM email address. Once this is done, you will receive an email from HCM confirming your membership.

Alumni or Student: RM200 lifetime fee

Associate or Friends of HCM: RM300 lifetime fee

If payment is not made and proof of payment is not emailed over, then this application form is considered null and void.

Please make payment to:

Bank Name: OCBC Bank

Account Name: Yayasan Kelab Harvard di Malaysia

Account Number: 7011110888

Reference: HCM Membership - [insert category]

Please send your proof of payment to:

harvardclubofmalaysia@gmail.com

Title of Email:

HCM Membership payment - [insert name], [insert category]

(ex: "HCM Membership payment - John Lee, Alumni")

Yes I have made the payment and sent the email to HCM

No I have not made the payment and therefore this application is null and void

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms