Registration | Parti Gerakan Rakyat Malaysia

PARTI GERAKAN RAKYAT MALAYSIA
Registration No. 373(SELANGOR)
P: 03-92876868 F: 03-92876868

LEVEL 5, MENARA PGRM
8, JALAN PUDU ULU
CHERAS
56100 KUALA LUMPUR

1/7Please choose your desired type of membership/请选择您想要的会员类型

Annual/年捐

RM2.00

Annual +4 Years Subscription

RM10.00

Lifetime/永久党捐

RM50.00

* Membership Fees are non-refundable/会员费不予退还 Terms & Conditions
Privacy Policy
Refund Policy

2/7Please Fill in the State/Division/Branch/请填写州/区部/分部

3/7Please fill in your personal details/请填写您的个人资料

4/7Please provide your address details/请提供您的地址

Correspondence same as Resident/Office/邮寄地址与以上相同

5/7Please upload your NRIC & passport size picture/请上传您的身份证和护照尺寸图片

NRIC/身份证号码 Front Side/前页

NRIC/身份证号码 Back Side/后页

Passport Size/护照尺寸 Picture/图片

6/7Please provide your family's details/请填写您的家人资料

7/7Please provide your proposer details/请提供您的提议者资料

I, the undersigned whose particulars are given above, hereby apply to be a member of Parti Gerakan Rakyat Malaysia and i agree, if admitted, to comply with the constitution and the rules of the party, and to carry out the objectives programme, principles and policies to the best of my abilities. I declare that i am not a member of aony political party. /余谨以至诚，愿遵循马来西亚民政运动党章，条规，并致力于党的目标，政纲，原则及政策，而申请为党员，谨此宣誓，余非其他政党之党员。

1/6Summary

1
Application Details
- Membership Type/会员选项:
- State/州:
- Divison/区部:
- Branch/分部:
2
Applicant Details
- Name/姓名:
- Old NRIC/旧身份证号码 (e.g. A123456):
- New NRIC/新身份证号码 (e.g. 123456789012):
- Place of Birth/出生地:
- Date of Birth/出生日期:
- Gender/性别:
- Marital Status/婚姻状况:
- Correspondence Address/邮寄地址:
- Post Code/邮区号码:
- City/城市 :
- Telephone/电话:
- Mobile/手提电话:

3/6Summary

3
Applicant Details
- Resident/Office Address/住宅/办事处地址:
- Office Post Code/邮区号码:
- City/城市:
- Telephone/电话:
- Fax/传真:
- Email/电子邮件:
- Occupation/职业:
- Highest Education Attained/最高学历:
4
NRIC & Picture Details
- NRIC/身份证号码 (Front Side/前页):
- NRIC/身份证号码 (Back Side/后页):
- Picture/图片 (Passport Size/护照尺寸):

5/6Summary

5
Family Details
- Family Member Name/家人姓名:
- Family Member NRIC/身份证号码:
- Family Member Mobile/手提电话:
- Family Member Relation/关系:
- Family Member Name/家人姓名:
- Family Member NRIC/身份证号码:
- Family Member Mobile/手提电话:
- Family Member Relation/关系:
6
Proposer(s) Details
- Proposer Name/提议人:
- Proposer Membership No/党员证号码:
- Seconder Name/附议人:
- Seconder Membership No/党员证号码:

Checkout：

Annual MembershipRM2

Annual +4 Years MembershipRM12

Lifetime MembershipRM52

FeesRM2

SubtotalRM4

SubtotalRM12

SubtotalRM52

1/7Please choose your desired type of membership/请选择您想要的会员类型

2/7Please Fill in the State/Division/Branch/请填写州/区部/分部

3/7Please fill in your personal details/请填写您的个人资料

4/7Please provide your address details/请提供您的地址

5/7Please upload your NRIC & passport size picture/请上传您的身份证和护照尺寸图片

6/7Please provide your family's details/请填写您的家人资料

7/7Please provide your proposer details/请提供您的提议者资料

1/6Summary

Application Details

Applicant Details

3/6Summary

Applicant Details

NRIC & Picture Details

5/6Summary

Family Details

Proposer(s) Details