SECOND SCHEDULE
PERSATUAN KEBANGSAAN DAYAK BIDAYUH
Lot 964, Block 10, Jalan Ong Tiang Swee
93200 Kuching, Sarawak
MEMBERSHIP APPLICATION FORM
[Article 7 (5)(a)]
(To be completed in duplicate) |
The Hon. Secretary,
................................................Branch,
Persatuan Kebangsaan Dayak Bidayuh(Dayak Bidayuh National Associaton)
..........................................................
Dear Sir,
I, the undersigned, wish to apply for membership in the .....................................Branch of
the Persatuan Kebangsaan Dayak Bidayuh(Dayak Bidayuh National Association). My personal
particulars are as follows -
| (i) | Name....................................................Sex...............NRIC No........................................ | | (ii) | Race/Original Village...................................................Nationality...................................... | | (iii) | Date and Place of Birth...................................................................................................... | | (iv) | Present Occupation............................................................................................................ | | (v) | Present Address(Home)..............................................Office.............................................. | | (vi) | Tel. & Fax Number (Home)..........................................Office............................................ | | (vii) | Married/Single................................................................................................................... |
2. I wish to be a Life member/Associate member/Ordinary member* and I enclose herewith a
cheque......................./cash in the sum of RM........................................
| | Entrance Fee | Subscription Fee (Annual) | | (i) | Ordinary membership fee | - | RM........................................................................... | | (ii) | Life membership fee | RM100.00 | RM........................................................................... | | (iii) | Associate membership fee | RM50.00 | RM........................................................................... | | (iv) | Donation (if any) | | RM........................................................................... | | | |
Total: RM_______________________________ |
3. I have not been/been member of the Association at its.........................................Branch.
4. I hereby declare that the above particulars are correct and true to the best of my knowledge
and belief and shall abide by and uphold the Constitution of the DBNA.
| Dated................... | .......................................................... | | (Applicants Signature ) |
| Proposed by...................................... | Seconded by...................... | | (Name & Signature) | (Name & Signature ) |
|
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