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Membership Application Form

The document is a membership application form for the Malaysian Institute of Estate Agents, offering various membership types such as Ordinary Member and Student Member. It requires personal and company information, payment details, and document uploads. The application also includes sections for office use and approval by the board.

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yn6husky
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19 views2 pages

Membership Application Form

The document is a membership application form for the Malaysian Institute of Estate Agents, offering various membership types such as Ordinary Member and Student Member. It requires personal and company information, payment details, and document uploads. The application also includes sections for office use and approval by the board.

Uploaded by

yn6husky
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEMBERSHIP MEMBERSHIP NUMBER:

APPLICATION
Tel: 03 7960 2577 Email : membership@miea.com.my

Membership being applied for:


Ordinary Member (OM) Student Member (SM)

Probationary Estate Agent Member (PEAM) Associate Member (AM)

Real Estate Negotiator Member (RENM) E/PEA/REN/V/PV/PM/PPM No:

I - PERSONAL PROFILE

Full Name: Mobile No: age:

NRIC: M/F DOB : Race:

Highest Educa�on Qualifica�on : Email Address :

Correspondence Address :

City : State : Poskod :

UPLOAD NAME CARD UPLOAD IC (front & back) UPLOAD REN TAG UPLOAD PHOTO

II - COMPANY PROFILE

Name of Company : Registra�on No. E / V / PM:

Office Tel no : Email address : Name of Principal:

PUBLIC BANK (MSIAN INST EST AG)


III - PAYMENT All Monies payable to Malaysian Ins�tute of Estate Agents | PUBLIC BANK BERHAD 3184
ACC NO: 1974
3184 197410
10

membership@miea.com.my
Amount Enclosed : Bank : Cheque Number :

MasterCard / Visa / Debit Card : Direct Transfer - Amount :

FOR OFFICE USE


Processing Membership Staff : Name: _____________ Date: ______________ Payment Mode : Date :
Cheque Bank Transfer
Cash Debit / Credit Card
Receipt No :
Approved by : Board of Directors Secretary General

The Secretariat
Malaysian Ins�tute of Estate Agents
Membership
Date: ______________ Unit C-27-05, Dataran 3 Dua, No.2 Jalan 19/1
Chairman’s Signature: ____________________
46300 Petaling Jaya, Selangor Darul Ehsan,
Malaysia.

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