APPLICATION FOR INDIVIDUAL MEMBERSHIP

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Personal Particulars
Full Name [As per NRIC]
NRIC No
Date of Birth[DD-MM-YYYY]
Age    Passport No
Citizenship
Residential Address
Post Code
City
Tel
H/Phone
Fax No
Email
Business or Office Address (P.O.Box please)
Post Code
City
General Line No
Fax No
Direct Line No
Email
 
CURRENT EMPLOYMENT / OCCUPATION
Designation
Date Appointed
No. of years in Current Position
Employer's Name
No of Employee in Organization
Address
Nature of Business
Total number of Employees directly reporting to you
Designation of your Immediate Supervisor
Designation of your Chief Executive
 
EMPLOYMENT

Please list your appointment / designations past to the present in chronological order giving reasons for any break in service, if any. Use a separate sheet if necessary

Employer's Name & Address Position Held From To
 
Education

(The highest qualification attained)

School, Colleges, University Date/From-To DURATION OF STUDIES GRADE / DIPLOMA DEGREE OBTAINED
Declaration
1) I hereby apply for admission to the Rolls of Membership of the Malaysian Institute of Human Resource Management, on the grade as deemed appropriate by the Council. I undertake to abide by the Constitution and will comply with the by-Laws, rules, policies and Code of Ethics of MIHRM during the currency of my membership.
2) I declare that all particulars and information supplied in connection with this Application are true and correct to the best of my knowledge and belief. If any of the above found untrue, I agree that MIHRM reserves the right to act accordingly.
3) I hereby authorize MIHRM Council or any of the Committee and Staff in the Secretariat to make reference checks and to use the information in this Application for whatever purpose (e.g. Inclusion into Directory)as may be necessary in furtherance to the objectives of MIHRM. Certification.
G9JA2326
                             
 
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