Professional Development Workshop Registration Form

PERSATUAN SENI RUPA MALAYSIA (PeRUPA)

PPM 014-14-21022013
Registration Form

Please fill in the form below.
Full Name*

PrefixFirst NameLast Name
IC or Passport Number*
Malaysia Citizen

YESNO
please state citizenship if not a citizen of Malaysia
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Please attach image of bank slip

Browse Files

Cancelof
Registration fees for Malaysian Citizen :

Annual registration : RM30.00

Lifetime registration : RM150.00

Registration fees for non citizen, living in Malaysia more than 3 years :

RM150.00

Persatuan Seni Rupa Malaysia accounts number

39869 63504 (Public Bank)
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