Online Application Form Membership ApplicaionApplicant's InformationFull Name *Your full nameNRIC or Passport No. *Your 12-digit NRIC number or passport number (for non-Malaysian)Nationality Your country of originGender MaleFemaleCompany or Business Name *Name of registered company or businessShort Business Description *Long Business Description Designation in Company Company Website URL Facebook Page URL Home Address Please include postal code for surface mail correspondence purposeBusiness or Office Address Please include postal code for surface mail correspondence purposeMobile Phone Number *Office Phone Number Office Fax Number Email Address Correspondence Preference For serving of notice of Annual General Meeting by postal serviceOffice AddressHome AddressApplication RequirementSponsor's Name, if any Sponsor must be an existing BNC memberType of membership applies *Ordinary Membership (Entrance Fee RM300, Annual Fee RM240)Associate Membership (Entrance Fee RM60, Annual Fee RM240)Important Notes Applicant is required to deposit the Entrance Fee & 1st Year Annual Fee into BNC's RHB Bank account (A/C No: 21220010146505) within five (5) working days after submission of this form, to facilitate processing. Total fees payable for ordinary membership is RM540, whereas ordinary membership is RM300. Cheque should be made payable to "Business Networking Club KL & PJ". Please forward a scanned copy of the proof of payment to bncklpj@gmail.com AttachmentsYour Photo *Please upload a photo that shows your face clearly.Business Card *Scanned copy or photo taken by cameraPayment Deposit Slip / Online Transfer Receipt Please attach copy of payment transfer record, if available VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: