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MARTS Membership Form (New)

The document is a membership application form for the Malaysian Amateur Radio Transmitters' Society (MARTS), a national society for amateur radio in Malaysia since 1952 and a member of the International Amateur Radio Union. The form collects an applicant's personal information such as name, address, contact details, and amateur radio license information. It outlines various membership fees including entrance fees, ordinary membership fees, associate membership fees, and affiliated membership fees. Upon completion, applicants must sign to declare the information is true and pay fees by check or money order made out to MARTS.

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Amin Aminuddin
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145 views1 page

MARTS Membership Form (New)

The document is a membership application form for the Malaysian Amateur Radio Transmitters' Society (MARTS), a national society for amateur radio in Malaysia since 1952 and a member of the International Amateur Radio Union. The form collects an applicant's personal information such as name, address, contact details, and amateur radio license information. It outlines various membership fees including entrance fees, ordinary membership fees, associate membership fees, and affiliated membership fees. Upon completion, applicants must sign to declare the information is true and pay fees by check or money order made out to MARTS.

Uploaded by

Amin Aminuddin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Malaysian Amateur Radio Transmitters Society

National Society for Amateur Radio since 1952


A Member of the International Amateur Radio Union

MEMBERSHIP
APPLICATION FORM

New Application Renewal, membership no. ... Previous/Lapsed Member Record Update
1. PERSONAL INFORMATION
Name:
Preferred name or Handle:

Call Sign(s):
Salutation:

Ex Call Sign(s):

Principal Members Name & Call Sign (for Family Membership):

Address:
Postcode & City:
Home Phone No.:

State/Province/Prefecture:
Mobile Phone No.:

Country:

Fax No.:

e-Mail Address:

Work or Other No.:

Personal Web Site URL:

http://
Date of Birth (dd/mm/yyyy):

Gender:

Malaysian Identity Card


New No.:

M F
Non-Malaysian
Citizenship:

Old No.:

Passport No:

Present Profession:

Organization:

2. FEES
Entrance (for new or pervious/lapsed membership)
Ordinary Membership (for 9M or 9W Malaysian Citizen licence holder only)

RM 20
RM 80 per year

Associate Membership (for non-Malaysian licence holder, & short wave listeners)

RM 50 per year

Affiliated Membership (for Clubs & Societies)

RM 80 per year
Total

* resides at the same address as the primary member, please also submit an additional membership form per family membership with

I enclose a cheque/postal order/money order, no. , drawee bank/PO ...,


of RM, made payable to Malaysian Amateur Radio Transmitters Society

4. DECLARATION OF APPLICANT/MEMBER
I declare that the above information given is true and correct, and this application is subject to the national
councils approval.
Applicant/Members Signature

Date (dd/mm/yyyy):

Proposer No 1 Sgnature

Proposer No 2 Signature

New transmitting membership application to attach a copy of Apparatus Assignment

Send to: MARTS, PO Box 10777, 50724 Kuala Lumpur, Malaysia Fax: +603 62727708 e-Mail: [email protected]

MARTS ADMINISTRATORS USE


Received by & date:

Data Entry by & date:

Receipt no.:

To bankin to Maybank Account No: 5-14093-22069-6 (Please write your name and callsign on the bankin slip and forward to the Secretary
or scan a copy and email to [email protected]

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