Receipt Submission
PARTI GERAKAN RAKYAT MALAYSIA
Registration No. 373(SELANGOR)
P: 03-92876868 F: 03-92876868
Contact us by Email: gerakan@gerakan.org.my
LEVEL 5, MENARA PGRM
8, JALAN PUDU ULU
CHERAS
56100 KUALA LUMPUR
© 2019 Parti Gerakan Rakyat Malaysia

1/7Please choose your desired type of membership/请选择您想要的会员类型

* Membership Fees are non-refundable/会员费不予退还 Refund Policy

** You must be at least 18 years of age to be able to join/您必须年满18周岁才能加入

2/7Please Fill in the State/Division/Branch/请填写州/区部/分部

3/7Please fill in your personal details/请填写您的个人资料

4/7Please provide your address details/请提供您的地址

5/7Please upload your NRIC & passport size picture/请上传您的身份证和护照尺寸图片

NRIC/身份证号码 Front Side/前页

NRIC/身份证号码 Back Side/后页

Passport Size/护照尺寸 Picture/图片

6/7Please provide your family's details/请填写您的家人资料

7/7Please bank in to the following account number & details: /请把费用汇入以下帐号:

1/6Summary

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    Application Details
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    Applicant Details
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3/6Summary

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    Applicant Details
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    NRIC & Picture Details
    • : NRIC Front
    • : NRIC Back
    • : Passport Size Picture

5/6Summary

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    Family Details
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    Proposer(s) Details
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Please bank in to the following account number & details: /请把费用汇入以下帐号:

5144 0480 5546

MALAYAN BANKING BERHAD

PARTI GERAKAN RAKYAT MALAYSIA

FeesRM2