Membership Membership Registration Form for the Gual Periok FoundationThis is a form for the membership of Gual Periok Foundation. All approved application will be placed as a Non-Executive Committee MemberPlease enable JavaScript in your browser to complete this form.Full Name *IC / Passport Number *Birth DateGenderMaleFemaleHome AddressCity / TownPostcode DropdownJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSelangorTerengganuSabahSarawakW.P. Kuala LumpurW.P. PutrajayaW.P. LabuanEmail *Phone Number * Highest Level of EducationSijil Pelajaran MalaysiaDiplomaBachelor's DegreeMaster's DegreeDoctor of Philosophy (PhD) as form Name of Educational InstitutionProfessionI hereby certify that all the information provided in this form is true, accurate, and complete to the best of my knowledge. I understand that any false or misleading information may result in the cancellation of my participation in the Foundation's activities, as well as the revocation of my membership, volunteer status, or partnership. I accept full responsibility for the accuracy of the information provided and agree to promptly notify the Foundation of any changes that may occur. *AgreeBy completing this membership application form, you agree that the Gual Periok Foundation (YGP) may collect, use, and disclose your personal data, as stated in this application form, or (if applicable) obtained by our organization as a result of your membership, for the following purposes in accordance with the Personal Data Protection Act 2010: (a) processing of this membership application; (b) administration of membership with our organization; and (c) implementation of activities by our organization. *AgreeSubmit
