MEMBERSHIP REGISTRATION

PERSONAL DATA
Person Title *
Name (IN FULL) *
MyKad / Passport No * /
Nationality / Citizenship *
Gender *
Male Female Data not entered        
Date of Birth * (dd-mm-yyyy)
Present Appointment / Job Title *
Hospital / University Name *
Office Address *
Postcode:
Town/City:
State:
Country:
Tel: (eg: 03-45678900)
Fax: (eg: 03-45678900)
Mobile Number * (eg: 012-3456789)
Email Address *


PROFESSIONAL QUALIFICATIONS
Academic Qualifications (Year: )
Date of completion of nephrology training (dd-mm-yyyy)
National Specialist Register No


PROPOSERS (two ordinary/life MSN members who personally acquainted with the applicant as to his professional eligibility)
Proposers 1
Proposers 2
To support your application, you are required to upload the application form with the chop & signature of the proposer.

MEMBERSHIP CATEGORY
  Life Member
(For Nephrologist only)
  • Physicians practicing in Malaysia who have postgraduate qualifications in Nephrology or Paediatric Nephrology
 Ordinary Member
(For Nephrologist only)
  • Physicians practicing in Malaysia who have postgraduate qualifications in Nephrology or Paediatric Nephrology
 Associate Member
  • Medical Graduates who are undergoing training programmes in Nephrology as recognised by the Society; OR
  • Surgeons or Physicians who maintain a continuous interest in Nephrology while practising in a closely allied speciality; OR
  • Medical Practitioners who have interest in Nephrology; OR
  • Those practising other non-allied medical sciences but having a keen interest in Nephrology.
 Corporate Member
  • They shall be elected from any commercial or private organisation interested in supporting the objectives of the society
Entrance Fee (RM) 100.00 10.00 10.00 500.00
Annual Subscription (RM) - 5.00 5.00 250.00
 
Years of Subscription -
Total Fee (RM)


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