membership application form untuk members 18 tahun dan keatas
TRANSCRIPT
Persatuan Sukan Ekuestrian Negeri Sarawak (Sarawak Equestrian Sports Association)
RM 2.00 / form
MMeemmbbeerrsshhiipp AApppplliiccaattiioonn FFoorrmm AAnnyy ppeerrssoonn wwiisshhiinngg ttoo ppaarrttiicciippaattee iinn tthhee aaccttiivvii ttiieess//pprrooggrraammss oorrggaanniizzeedd bbyy tthhee PPeerrssaattuuaann SSuukkaann EEkkuueessttrriiaann NNeeggeerrii SSaarraawwaakk ((PPSSEENNSS)) mmuusstt bbee aa MMeemmbbeerr ooff tthhee
PPSSEENNSS.. EEnnttrriieess wwii ll ll nnoott bbee aacccceepptteedd ffoorr aannyy iinnddiivviidduuaall wwhhoo iiss nnoott aa MMeemmbbeerr..
I wish to apply for Membership to the Persatuan Sukan Ekuestrian Negeri Sarawak and in doing so, declare that I agree to abide by the Persatuan Sukan Ekuestrian Negeri Sarawak’s Rules and Regulations. I declare that the information I provide on this Application Form is true and correct.
Reminder: Supplying false, incorrect or misleading information may lead to disqualification from being a member of PSENS.
Membership Registration Fee: RM50.00 Annual Subscription Fee: RM50.00
Cheques/Money Order/Cash payable to: Persatuan Sukan Ekuestrian Negeri Sarawak.
Name: ……………………………………………………………………………………………………
IC / Passport No: …………………………………………………………………………………………………...
Date of Birth: ……………………………………………………………………………………………………
Address: ……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
Postcode: .............................................
Telephone: ………………………… E-Mail: ……………………………………………………
Signature: …………………………………………….. Date: …………………………………..
Next of kin (Full name) : ………………………………………………………………………………………………..
H/P No: ……………………………………………..
Signature: …………………………………………………. Date : ………………………………
Please complete & return this Membership Application Form, accompanied by your recent passport size photos (2 pcs), a photocopy of your IC and RM100.00 (Ringgit Malaysia One Hundred Only) (Cash/Cheque/Money Order) Fee payable to the “Persatuan Sukan Ekuestrian Negeri Sarawak”. Please take note that PSENS have the right to accept or to reject any application to be a Member. Any unsuccessful application will be notified and payment will be refunded in full. (Membership registration & Annual fee).
Persatuan Sukan Ekuestrian Negeri Sarawak Lot 3427 Kpg Sinar Budi Baru, Lrg 17 Tmn Desa Wira
93250 Jalan Batu Kawa, Kuching Tel: 019-8770074 E-Mail: [email protected]