Join as a Member

01 Membership Type

Ahli Biasa

Regular Member — 18+, Kelantan resident

Ahli Bersekutu

Associate Member — outside Kelantan

Ahli Remaja

Youth Member — under 18

02 Personal Information

Full Name (as per IC)

Malaysian IC Number (No. Kad Pengenalan)

Date of Birth

Place of Birth

Gender

Race / Ethnicity

Religion

Nationality

03 Contact Details

Phone Number

Email Address

Home Address (Alamat Rumah Kediaman)

04 Occupation & Employment

Required for the Secretary's membership register (Fasal 9.3)

Occupation / Job Title

Employer / Organization

Employer Address / Work Location

05 STEM Interests & Expertise

Areas of Interest (select all that apply)

Science / Sains Technology / Teknologi Engineering / Kejuruteraan Mathematics / Matematik Innovation / Inovasi Education / Pendidikan Tech Entrepreneurship Community Service

How did you hear about PaKSI?

06 Guardian / Parent Information

Required for Ahli Remaja (under 18) — Fasal 4.1(E)

Guardian Full Name

Guardian IC Number

Guardian Phone

Guardian Email Address

Relationship

A signed guardian consent letter must be submitted to the Secretary before membership is approved. The Jawatankuasa will provide the consent form template upon receipt of this application.

07 Proposer & Seconder

Per Fasal 4.2, applications must be proposed and seconded by existing members. Leave blank if you don't have contacts — the committee will assist.

Proposer Name (Pencadang)

Seconder Name (Penyokong)

08 Declaration & Agreement

I hereby apply for membership in Persatuan Kemajuan STEM & Inovasi Kelantan (PaKSI) and declare that all information provided is true and accurate.

I agree to abide by PaKSI's Perlembagaan and all rules, and to pay the RM 10.00 registration fee as part of this application. I understand that if my application is not approved, the fee will be fully refunded. The annual renewal fee of RM 50.00 applies from the second year onwards.

I understand the Jawatankuasa reserves the right to accept or reject any application without providing reasons (Fasal 4.2).

Refund Policy: The RM 10.00 registration fee is fully refundable if your application is not approved by the Jawatankuasa. Refunds will be processed within 14 working days.

I have read and agree to abide by PaKSI's Perlembagaan and all association rules. I consent to PaKSI collecting and storing my personal data for membership administration purposes. I declare all information is accurate. False declarations may result in rejection or termination of membership.

Payment is required to submit your application. A full refund will be issued if your application is not approved by the Jawatankuasa.

Payment Received!

Application Recorded!