CAM

CHEVENING ALUMNI MALAYSIA (CAM) MEMBERSHIP APPLICATION FORM

Persatuan Alumni Chevening Malaysia
(reg. no. PPM-001-14-27041996)

* indicates required

Email Address *

Title

Tan Sri/Datuk/Dato'/Dr./Mr./Ms.

Full Name as per MyKad *

Year(s) of Scholarship i.e. 2017/2018 *

MyKad Number

i.e. "900114-35-5176"

Current Profession and Workplace *

University *

Programme of Study *

Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Contact Number (With Country Code) i.e.60123456789

Membership in Other Organisation (Name of Org.).

Position Held in the Organisation

Membership Fee *

Yes. CAM membership is a one-time life membership of RM100.00 only. Please make online payment to CIMB Bank Acct #8000550417 and notify us at cheveningalumnimalaysia.cam@gmail.com with bank transfer statement once you have made payment.

Constitution *

By submitting this form, I hereby agree to abide by the rules and regulations stipulated in the Constitution of the Alumni. Kindly e-mail us at cheveningalumnimalaysia.cam@gmail.com to request for a copy of the Constitution.

Communication

By signing up as a Life Member, I agree to include my contact details in the database so that information can be sent to me by the Chevening Alumni of Malaysia. I acknowledge that should I wish to cease receiving such communications I will have to notify the Chevening Alumni of Malaysia to remove my contact from the communications list.

Data Sharing

The CAM Committee is occasionally approached by CAM members who seek to connect with other alumni members in their field. Do you consent to sharing your professional and contact information with CAM members who request it from the CAM Committee? Yes, I consent to sharing my contact information with CAM members who request it
No, my information should only be accessible to the CAM Committee

Data Protection *

I agree to CAM Personal Data Protection Policy. https://drive.google.com/file/d/1lbzxft_09iPvz_rXt85

Please sign Full Name below to acknowledge

Full Name as per MyKad.

Chevening Alumni Malaysia (CAM) New Member Registration Form