MEMBERSHIP APPLICATION FORM
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INSTRUCTIONS TO APPLICANTS
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1. Complete the following particulars.

2. Applications are open throughout the year.

3. Please send this file as attachments to gscfmhs@yahoo.com.

4. Applications will be processed and applicants will be notify.

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PERSONAL INFORMATION
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Name			:

Age			:
	
Sex			:	

Nationality		:	

Matric No.		:
	
NRIC/Passport No.	:

Department		:

Registered Degree	:
	
Field of Study		:

Scholarship			:

Mailing Address		:
	
Telephone (Home)		:
	
Telephone (Office)	:

Fax (if available)	:

Email				:

PROPOSED PORTFOLIOS	:

CODE				:

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PLEASE DO NOT FILL THIS SECTION
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Received and processed by	: _______________________

Date 				: _______________________

Action(s) taken 		: