Rohingya Youth Association (RYA)
Malaysia
႐ိုဟင္ဂ်ာ လူငယ္မ်ား အသင္း၊မေလးရွား
Membership Application Form
Title : --------------(Dr./Mr./Mrs/Miss)
Full Name :---------------------------------------------------------
Date of Birth : ---------------------------------------------------Place
of Birth :-------------------------------
Marital Status
:----------------------------------------Occupation : -----------------------------------
Education
Qualification:--------------------------- Language Skills:
---------------------------------
Current
Address:----------------------------------------------------------------------------------------
Permanent Address:
------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------
Telephone No: (Mobile) -------------------------------------
(Home) --------------------------------
E-mail: -----------------------------------------------------------
Web:---------------------------------
Terms & Conditions for RYA Membership
1) Member must abide by the constitution, rules and regulation of
the RYA.
2) Member must pay the monthly membership fee within first week of
the month.
3) Member must attend meetings
and programs of the RYA to be held from time to time.
Declaration
I confirm that, to the best of my knowledge and belief, the
information provided above is complete and correct. I understand that omitting
and misrepresenting any relevant facts may subsequently affect my membership
being refuse or terminated.
Signature: ____________________ Date: __________________
Recommended By:
___________________ Signature:
_______________
Office Use
Only:
Admissions fees; RM _________
Admitted / Refuse: __________________
Admissions
Date: _________________
Membership No.: __________
General
Secretary Signature; __________
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