The Oxford & Cambridge Society Malaysia

Please fill in ALL the fields for your application to be expedited.

Date:

To the Honorary Secretary,

Oxford & Cambridge Society, Malaysia
c/o Sharon Saw (Phone/Fax no: 03 – 20944995)
369 Lorong Maarof, Bukit Bandaraya
59000 Kuala Lumpur

I wish to apply for membership of the Oxford and Cambridge Society, Malaysia.

I will send my non-refundable membership fee of RM100,
by Cheque no:
(payable to "The Oxford and Cambridge Society, Malaysia") to the address above.

I declare that I have for: term(s) at , and that the information I provide below is true, accurate and complete:

Title	:
Surname	:
First name (s)	:
NRIC	:
for non-Malaysians Passport number	:	Country:
Home Address	:
Mailing Address (If different from home address )	:
Telephone Numbers Mobile	:
Office	:
Home	:
Email Address	:	Please send notices by email
College	:
Dates of Residence	:
Degree(s)/Program(s)	:
Name of spouse, if married	:

I agree that :

(a) the above information is not confidential and may be used for the purposes of the Society, and I will promptly notify the Society of any changes;
(b) I will produce relevant documents promptly on request;
(c) the Committee of the Society need not give any reason for rejecting my application; and
(d) by submitting this application, I will be bound by the above terms and conditions and the Rules of the Society in force from time to time.

Agree Disagree