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MII-KC Online Membership Application Form

Type of
Membership		 Annual Fee
(RM)		 Card
(RM)		 Deposit
 (RM)
Gold 30.00 20.00 150.00   Reference & borrowing
Silver 30.00 20.00 -   Reference only
 Application :

Type of Membership

  Gold Silver

 
 Personal Details :

Full Name

NRIC No ONLY

 - -

Occupation

Home Address

(permanent)

 

Postcode

   State

House Tel No

H/Phone No

Email
   

Company Name

Company Address

 

 

Postcode

   State

Office Tel No

Office Fax No
   

Your membership application is still pending waiting for you to make the payment.

You may pay by bank-in to our RHB Account :
 

- Bank Name

 : RHB Bank

- A/C Name

 : The Malaysian Insurance Institute

- A/C Number

 : 2 6 4 1 6 0 0 0 0 0 4 6 7 0

- Payment Method

 : Cash / Cheque Deposit

 

  

We will process your membership application after receiving your payment confirmation via email or fax.
   

  For any enquiries, please contact us at zamri@mii.org.my / harizam@mii.org.my or tel: 603-2087 8882 ext. 270