08:34:39 PM Thursday, 17 May 2012
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Malaysian Rubber Exchange

Permohonan Keahilian Bersekutu

Form No. II
Application For Associate Membership Of The
Malaysian Rubber Exchange
           
1.
Name of Applicant : Company's Name
Official Address :
City :
State (for Malaysia only) :  
Country :  
Zip / Postal Code :  
Tel No :
Ctry
Code		 Area
Code		 Tel Number
Fax No :      
E-mail :
                                                                              
  2. (a) Constitution of Business :  


 
   
(b) Date of Incorporation/Registration : dd/mm/yyyy
(c) Country of Incorporation/Registration :
     
  3. (a) Nature of business in :
    (b) Number of years in rubber/rubber products business:
     
  4. Paid-up Capital 
Amount (RM) :  
 
  5. Bank Guarantee (if applicable)
Amount (RM) :  
Banker's Name :
Address :
   
 
  
  6. Particulars of Directors/Partners*:
Name :
Residential Address :
Designation :
Nationality :
Occupation Vitae :
Shares in Company if any :  
 
Name :
Residential Address :
Designation :
Nationality :
Occupation Vitae :
Shares in Company if any :  
 
Name :
Residential Address :
Designation :
Nationality :
Occupation Vitae :
Shares in Company if any :  
* as at date of application
     
   7. Principal Officers :
Name :
Position in Company :
Nationality :
Occupation Vitae :
Experience in Rubber Trade & Industry :
Shares in Company if any :  
 
Name :
Position in Company :
Nationality :
Occupation Vitae :
Experience in Rubber Trade & Industry :
Shares in Company if any :  
 
Name :
Position in Company :
Nationality :
Occupation Vitae :
Experience in Rubber Trade & Industry :
Shares in Company if any :  
 
  8. Trade Association/Affiliation (if any):
   
      
  9. Bank Confidential Report from :
Name of Bank :
Address :
   
Applicant's Name :
Designation :
Application Date : 17 May 2012
      
    By submitting this form, you indicate that you agree to forward your application to the Malaysian Rubber Exchange for processing to become a member.
     
       
 
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