MOPI Online Application Form for Associate Membership (Associations)

Malaysian Organisation of Pharmaceutical Industries
1st Floor, Wisma Yan,
No 17 & 19, Jalan Selangor
46050 Petaling Jaya, Selangor
Tel : 603-79573070 Fax : 603-79560018 Email : mopi@streamyx.com

Name of Association	:
Address	:
RoS Reg. No	:
Date of Reg	:
Number of Members:	:	(please provide names & addresses of members as an attachment)
Your Associations' Entrance Fee RM	:
Your Associations' Annual Subscription RM	:
Name of Office Bearers (to update annually)	:
President	:
D-President	:
V-President	:
Secretary	:
Treasurer	:
Committee	:

We when elected an Associate Member of the Malaysian Organization of Pharmaceutical Industries (MOPI) agree to abide by the Articles of Association of MOPI.

Signature & Stamp of Association :

Name & Designation of Signatory--:

Date ..........................................:

Approved by MOPI Exco on .........:

Click to or