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    MIArb Membership Application Form

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    FawwazFikri13
    This document contains a membership application form for The Malaysian Institute of Arbitrators. The form requests personal details such as name, contact information, academic qualifications, experience in arbitration, membership in other professional bodies, occupation, and the grade of membership being applied for. It notes that supporting documents must be enclosed and certified copies of qualifications and certificates are required. The form is to be completed and returned with payment for the membership grade applied.

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    Download as PDF, TXT or read online from Scribd

    MIArb Membership Application Form

    Uploaded by

    FawwazFikri13
    49 views3 pages
    This document contains a membership application form for The Malaysian Institute of Arbitrators. The form requests personal details such as name, contact information, academic qualifications, experience in arbitration, membership in other professional bodies, occupation, and the grade of membership being applied for. It notes that supporting documents must be enclosed and certified copies of qualifications and certificates are required. The form is to be completed and returned with payment for the membership grade applied.

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    MiArb Application form

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    This document contains a membership application form for The Malaysian Institute of Arbitrators. The form requests personal details such as name, contact information, academic qualifications, experience in arbitration, membership in other professional bodies, occupation, and the grade of membership being applied for. It notes that supporting documents must be enclosed and certified copies of qualifications and certificates are required. The form is to be completed and returned with payment for the membership grade applied.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views3 pages

    MIArb Membership Application Form

    Uploaded by

    FawwazFikri13
    This document contains a membership application form for The Malaysian Institute of Arbitrators. The form requests personal details such as name, contact information, academic qualifications, experience in arbitration, membership in other professional bodies, occupation, and the grade of membership being applied for. It notes that supporting documents must be enclosed and certified copies of qualifications and certificates are required. The form is to be completed and returned with payment for the membership grade applied.

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    CONFIDENTIAL

    MEMBERSHIP APPLICATION FORM

    Apply for Grade of (please tick box provided) :


    Associate Affiliate Member Corporate Member Fellow

    For Office Use Only:


    Membership No. PHOTO (within 37x42mm)

    Grade elected Approved on

    1. PERSONAL PARTICULARS Name (BLOCK LETTERS) :

    *Title / Mr / Mrs / Miss / others : NRIC / Passport No. (New) : Date of Birth (dd/mm/yyyy) : Home Address : (Old) : Nationality :

    Telephone No. : Company Name / Firm : Address :

    Mobile No. :

    Telephone No. : E-Mail :

    Facsimile No. :

    *All correspondence should be sent to office/ home address: THE MALAYSIAN INSTITUTE OF ARBITRATORS

    Unit 508, Lobby 2, 5th Floor, Block A, Damansara Intan, Jalan SS20/27, 47400 Petaling Jaya, Selangor, Malaysia. Tel: (603) 7726 5311 Fax: (603) 7726 5322 Email: miarb@streamyx.com / info@miarb.com

    2. ACADEMIC QUALIFICATIONS, EXPERIENCE & MEMBERSHIP

    2.1 Tertiary Education, Degrees, Diplomas, Certificates Awarded (and field of study) (supporting details, documents and references should be enclosed)

    *Please attach additional sheets if space is insufficient.

    2.2 Arbitration Experience, Capacity & Extent Of Involvement (supporting details, documents and references should be enclosed)

    *Please attach additional sheets if space is insufficient.

    2.3 Membership of Any Professional, Trade, Industrial or Other Bodies and Positions Held

    *Please attach additional sheets if space is insufficient.

    2.4 Present Profession/Occupation

    *Please attach additional sheets if space is insufficient.

    THE MALAYSIAN INSTITUTE OF ARBITRATORS

    Unit 508, Lobby 2, 5th Floor, Block A, Damansara Intan, Jalan SS20/27, 47400 Petaling Jaya, Selangor, Malaysia. Tel: (603) 7726 5311 Fax: (603) 7726 5322 Email: miarb@streamyx.com / info@miarb.com

    3. MEMBERSHIP UPGRADING

    3.1 If you are applying for upgrading of membership, please state present grade and membership no.

    Grade :

    Membership No. :

    PROPOSER Signature :

    SECONDER Signature :

    Name : Grade : M/No. :

    Name : Grade : M/No. :

    I, the undersigned applicant, hereby declare and confirm that all the abovementioned facts and details are true and accurate. Date : Signature of Applicant. :

    Note: The form is to be completed and returned together with a cheque of amount as required for the grade of membership applied and made payable to The Malaysian Institute Of Arbitrators. In the event the Council decides that a candidate qualifies for election as a member of a higher category in accordance with the Rules then the candidate concerned shall be liable to pay the difference in the annual subscription fees between the categories upon formal acceptance. If the application is not accepted, payment will be refunded in full. Please enclose copies of your qualifications and certificates of membership from other professional bodies and a passport size photograph. Copies of documents sent together with this application must be certified by a member of the Institute, or any Advocate & Solicitor, or by a Commissioner for Oaths, or by an Officer of Court, or by a Division A Officer in Government Service.

    THE MALAYSIAN INSTITUTE OF ARBITRATORS

    Unit 508, Lobby 2, 5th Floor, Block A, Damansara Intan, Jalan SS20/27, 47400 Petaling Jaya, Selangor, Malaysia. Tel: (603) 7726 5311 Fax: (603) 7726 5322 Email: miarb@streamyx.com / info@miarb.com

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