Associate MembershipRM36.00Associate Membership shall be open to medical doctors and other health care professionals interested in intensive care.Life MembershipRM1,200.00Any Ordinary Member may apply for life membership on payment of RM1200.00 and henceforth shall be exempted from paying the yearly subscriptions. An additional amount of RM10 shall be paid as entrance fee by those who apply to join and who opt for life membership immediately.New MemberRM2.00For testing purposesOrdinary MembershipRM60.00Ordinary Membership shall be open to Registered Specialists interested in Intensive Care.Select Your Payment CycleGoldNextPreviousApplicant Particulars Membership ID * Title * Full Name* GenderMaleFemale * Email Address * Correspondence Address * City * State * Postcode * Mobile No. Tel. No. (Office) Tel. No. (Home) * Date of Birth * New IC No. * Preferred PasswordStrength: Very WeakQualification * Name and abbreviation of Qualification (Degree/Diploma) [1] * Institution name [1] * Year of completion [1] Name and abbreviation of Qualification (Degree/Diploma) [2] Institution name [2] Year of completion [2] * Present Appointment & AddressRecommendation Proposed and seconded by (Must be members of the Society) * Proposed - Name * Proposed - Address Seconded - Name Seconded - AddressPayment ProofDone(Use Cropper to set image and use mouse scroller for zoom image.)Done(Use Cropper to set image and use mouse scroller for zoom image.)Drop file here or click to select. Select Your Payment GatewayStripeBank TransferName Of Account: Malaysian Society of Intensive Care Number Of Account: 873-1-5662806-4 Name Of Bank: Standard Chartered Bank Berhad Address Of Bank: Kuala Lumpur Branch, Lot 4&5, Level G2, Publika Shopping Galley, Solaris Dutamas, 50480 Kuala Lumpur Swift Code: SCBLMYKXXXXTransaction IDTransaction IDPlease enter Transaction ID.Bank NameBank NamePlease enter Bank Name.Account Holder NameAccount Holder NamePlease enter Account Holder Name.Additional Info/NoteAdditional Info/NotePlease enter Additional Info/Note.Payment ModePayment ModeCashSelect Payment ModeDigital TransferChequeCashHow you want to pay?Auto Debit PaymentManual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: SubmitAlready have an account? Login
