Member Application Form

Home Member Application Form

* All the details are mandatory and kindly ensure accuracy of details
* Upon approval by the committee member, the secretariat will inform you via email for payment of
membership fees. Banking details will be provided
* to update personal details (e.g. email, mobile number, place of practice & etc) kindly email to secretariat@msr.my

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Name

Date Of Birth

Sex

Occupation

Specialty

Place of Practice

Address (Work)

Postcode

State

Tel

Mobile

Email Birth (Work)

Current Position

Reason of Application

Reference

Please name a current MSR Member for us to verify your involvement in rheumatology

Ordinary Member

Entrance Fee - RM100.00
Annual Subscription - RM50.00
Five years’subscription - RM250.00

Associate Member

Entrance Fee - RM30.00
Annual Subscription - RM10.00
Five years’subscription - RM50.00

Corporate Member

Entrance Fee - RM1000.00
Annual Subscription - RM500.00
Five years’subscription - RM2500.00

* For paramedic

Member Application Form

MSR

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