Malaysian Ultra Runners Association (MURA)

Malaysian Ultra Runners Association (MURA)
Application Form (Ordinary or Associate members). You will need to attach the payment receipt to this form to proceed further. The payment receipt must show: MURA bank account, amount paid, date and transaction status (success). The fee is RM50 per year of membership. Payment must be made to:

MALAYSIAN ULTRA RUNNERS ASSOCIATION
Maybank
Acct: 5647 1751 7055

Your application will be processed as soon as possible within 2 weeks.
Name*
Photo (passport size)*

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Sex*
IC / Passport No*
Nationality*
Date of birth*
Age*
Occupation*
Company name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email address*
example@example.com. Kindly use your own email address.
Contact number*

Area CodePhone Number
I have run successfully in the last 2 years
Some information about your longest succesfully completed race in the last 2 years (ultra marathon). If you have not ran an ultra marathon, please fill in with your most recent full marathon 42.195km.
Race Name*
Race - Country/location*
Race - Year*
Race - What was the distance*
Race - Your certificate or race results*

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What is your longest road distance completed in an ultra marathon race (no DNF) ?*
What is your longest trail distance completed in an ultra marathon race (no DNF) ?*
Payment Receipt*

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