Annual Subscription Form Annual subscription is due on the 1st day of January of the current yearAnnual subscription fee : Ordinary Member RM100 Affiliate Member (Malaysian) RM100 Affiliate Member (Foreigner) RM200 Associate Member US100 Corporate Member RM1000Type of Member Ordinary Member Affiliate Membership Corporate Member From Year (Required) :Please enter a number greater than or equal to 2014.Until Year (Required) :Please enter a number greater than or equal to 2015.Name NRIC NO Contact No Member I.D. Email Address PaymentTo be made upon submission By Cheque Deposit By Interbank Online Transfer Name of Account Holder : Persatuan Perubatan Integratif Malaysia Name of Bank : Alliance Bank Malaysia Berhad Bank Account No. : 141760010054697 Bank SWIFT Code : MFBBMYKLAmount : RMPlease email Cheque Deposit Slip to info@integrativemedicinemalaysia.org or by fax.Browse scanned cheque / bank in slip : ( max. file size limit to 2MB & only allow format pdf, docx, txt, csv, jpg, png and gif )Max. file size: 2 MB.
