Registration

Fields marked with asterisk * are required.

Personal Information
Salutation*
First Name*
Last/Family Name*
Gender*
Birth Date* Day Month Year
Citizenship*
Marital Status*
E-mail*
Phone Number 1*
Phone Number 2
Phone Number 3
Mailing Address
Street 1*
Street 2*
City*
State*
Postcode*
Country*
Current Company*
Current Job Title*
Educational Background 1
Name of University*
City and State*
Graduation Year*
Degree
(B.Sc/BA/M.Sc/MBA/PhD)*
Field of Study*
Educational Background 2
Name of University
City and State
Graduation Year
Degree
(B.Sc/BA/M.Sc/MBA/PhD)
Field of Study
Types of AUAM Event that interest you (Please tick)
Annual Dinner
U.S. Education Fair
Reach out to U.S. bound students
Luncheons / Dinners / Gatherings
Intellectual Events (Debate/Forum/etc)
Charitable Activities
Other Activities (please write)
Preferred Frequency and Date of AUAM Events (Please tick)
Frequency of Events Once a fortnight
Once a month
Once a quarter
Once a year
Preferred Time of Events Weekdays Lunch Time
Weekdays Evening
Saturday
Sunday
Subscription Fee

Note: Cheques are to be crossed and made payable to AUAM. Receipt will be issued and mailed to your address within 90 days after your check has been received.

Life MembershipRM50.00 one-time fee
Ordinary MembershipRM20.00 per year (Malaysians)
Associate MemberRM10.00 per year (Non-Malaysians and Parents)
Payment Information

Note: Cheques are to be crossed and made payable to AUAM. Receipt will be issued and mailed to your address within 90 days after your check has been received.

Category of Membership*
Payment Amount (RM)*
Method of Payment*
Bank draft / Cheque Number
Issuing Bank
Terms and Conditions

Please review the following terms and indicate your agreement below.

By clicking "I agree", you agree and consent to the AUAM Terms and Conditions of Service and Privacy Policy.