NEW
Member RENEWAL
Membership#
I am proud
to be Assuntarian and hereby apply for Ordinary Membership to Assunta Alumni
and agree to be bound by all its rules
and regulations.
M Y D E T A I L S
Full Name
(as
in IC)
Nickname
(known
in school as)
Title
(e.g.
Ms/Mrs/Dr/Dato'/Puan Sri)
Date of Birth
(dd/mm/yyyy)
Years at SM Assunta
(e.g.
1962-1966)
House
I
now big-time Profession
I
C A N B E R E A C H E D A T
HOME (Permanent)
Addresss
Town/City
Postcode
State
Country
MAILING Address
Postcode/City
State
Country
CYBER Home
E-mail
Phone
Mobile
Fax
M y
A
S S U N T A S P I R I T
l i v e s o n !
Volunteer my
services:Please
select...Champion Mindmap Projects
Choose your area of interest at
the AA Mindmap.
Others:
F E
E S A N D M E T H O D O F
P A Y M E N T
New Member Registration
Fee : RM10
Annual Subscription
Fee: RM10
Advanced Subscription: Please
select...
Take advantage
of this option NOW to enjoy the current rate for as many years as you want!
Otherwise,
renewals subjected to published rates decided by future committees.
Cheque / Bank Draft (cashier's check)
No.
for RM
being payment for
Print this form and send with cheque
made payable to Persatuan Alumni Sek Men Assunta to:
Christina
Chan, Treasurer, Persatuan Alumni Assunta
PO Box 6603, Kampung Tunku, 47308
Petaling Jaya, Selangor Darul Ehsan, MALAYSIA.
-
A d
d i t i o n a l r e m a r k s / q u e s t i o n s ?
A L
L S E T ? :)
Gentle Reminder: 1. Please ensure your contact
numbers and email address above are correct. 2. Please print a copy
of this page to be snailmailed to Assunta Alumni with payment.
3. Click SUBMIT button below
once (ensure you are online).
4. Join Assunta
e-Alumni (newsgroup) to network and kept informed of happenings!
5. Need clarification?
Contact
us or email teammates@AssuntaAlumni.com
If the above information
is correct,
If you wish to start over,
