Pata Malaysia Chapter

Application Form

Be at the Forefront.
Be a member of the pioneering Pata Malaysia.

Name of Organisation

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Email *

Password *

Representative (Official)

Name *

Position *

Email *

Mobile *

Representative (Alternative)

Name *

Position *

Email *

Mobile *

Nature of Business *

Company Registration Details

Organisation is officially registered as (name of Company) : *

Date of Registration : *

Company Registration Number : *

Trade Licence Number from relevant Authority (if any) :

Membership type and fees

Entrance fee one time : MYR 300.00

Annual Subscription Fee : MYR 250.00

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PATA Malaysia Chapter 6 th Floor, No. 2, Tower 1, Jalan P5/6, Precinct 5, 62200 Putrajaya MALAYSIA

patamalaysia@gmail.com

603-8891 8957

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