Member Application Form

Type of Membership

Ordinary Life Membership - RM 300 + RM10 Entrance FeeOrdinary Member - RM30 a year + RM10 Entrance FeeAssociate Life Member - RM 300 + RM10 Entrance FeeAssociate Member - RM30 a year + RM10 Entrance Fee

Personal Data

Name (required):

Address:

Email:

Gender: MaleFemale

Date of Birth:

Company:

Are you still serving in any BB company? YesNo

Attach a copy of your photo here

I hereby declare that the above information are correct and will abide by the Constitution if Persatuan Stedfast Kuala Lumpur. I enclose herewith an attachment of the donation that I have made.

Kindly make your payment to PERSATUAN STEDFAST KUALA LUMPUR. Maybank Account No: 0-14039-32705-4

Once done, you may attach the receipt below.