TERM & CONDITIONS1. Membership registration fee RM50, annual fee RM50 & card RM7.2. All payment must be payable in cash or MBB#562106221613. Please retain bank slip for proof.3. The committee reserves the right to approve/decline membership without giving any reasons.4. All registration form must be submitted to the PRADAS Secretary.

DETAILS OF MEMBER APPLICATION

Name (as NRIC):

Home Address:

Postcode: City:

State: Country:

E-Mail:

Gender: Male Female NRIC:

Date of Birth: Tel (House):D D M M Y Y Y Y

Occupation:

Department:

Office Address:

Postcode: City:

State: Country:

Tel (Off): Tel (H/P):

Preferred Callsign: P R Amateur Callsign:

ACKNOWLEDGEMENT

Introducer Name: Callsign: P R -

Alternate Contact Person (emergency cases):

Tel: Relation:

I/we agree to accept and be bound by Term & Conditions which accompany the member of PRADAS.These Term & Conditions may be subjected to change by PRADAS and I/we will be notified in a manner,as PRADAS deems appropriate. I/we confirm that the information given herein by me/us is true and correct.

Date:Signature of Applicant

FOR OFFICE USE ONLY

Date of received application:D D M M Y Y Y Y

Reference / Membership No.:

Approved: Not approved:

Date:Official Signature/Call Sign P R - WEB PRADAS borang ahli v3

please attach photo here

APPLICATION FORM

Persatuan Peminat Komunikasi Radio Dua-HalaSelangor (PRADAS)C-10A-07, Lestari Apartement,Jalan PJU10-1B, Damansara Damai,47830 Petaling Jaya, Selangor.Tel.: 016-2348227Web: www.pradas.org.my