The purpose for this registration form is to acknowledge your online membership with us. This does not mean that you are an official member of the ICAAM, until we’ve received confirmation of your membership payment to us.

Upon sighting of payment you will receive an e-mail detailing your login details which will give you access to our wealth of services through our portal, as well as our unique ICAAM car sticker sent to your house address (or office address) that you have provided us with.

Note

• Please prepare cheque for RM160.00 payable to Imperial College Alumni Association Malaysia for Life Membership
• One passport size photograph of the applicant must be enclosed.
• Cheques and photos are to be submitted to the President, Associate Professor Dr Zainal Abidin Mior Ahmad at:

• Universiti Putra Malaysia
  Department of Plant Protection
  Faculty of Agriculture
  43400 UPM Serdang
  Selangor Darul Ehsan
  Tel: (603) 8946 7250
  Fax: (603) 8656 0698
  Email: zainalma@hotmail.com

• Please ensure application is in a legible manner (either in block handwriting or typewritten).

Method of Application:
• Print and complete this form and submit together with cheque & photo by mail; or
• Complete the form online and submit cheque & photo by mail; or
• Complete the form online and e-mail to info@icaam.org.my a scanned copy of your photo and online receipt once you’ve done payment through online transfer to

• CHRISTOPHER TOCK
  Maybank: 162535009606
  CIMB: 14170082460528