CORPORATE MEMBERSHIP APPLICATION FORM

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International Food Safety Conference 2012

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CORPORATE MEMBERSHIP APPLICATION FORM

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* Required Field

Name of Corporate Body (in full):*

Address:*

Telephone:*

Fax:

Email:

Website:

Contact Persons / Designation:

Details Of Corporate Identity

Government:

Statutory:

Education R&D Others

Education R&D Others

Company:-
Type:

Sole Proprietorship	Partnership	Pte. Ltd.
Unlisted Public Co.	Listed Public Co.

Main Business:

Manufacturer	Services	Importer	Exporter
Wholesaler	Retailer	Industrial Supplier
Others

Authorised Capital:

Paid-up Capital:

Major Shareholders / Directors:

Shareholders

Directors

Employment:

Total No.:
No. of Food Technologists:
MIFT Members:

Nominees
Corporate membership entitles the organisation to nominate two (2) employees of the organisation to participate in MIFT activities. Corporate nominees will enjoy all the benefits and privileges similar to individual members except the right to vote and to hold office in the MIFT Council.

Fill in details of nominees:

Name of Nominees	Designations

In the event that either one or both nominees cannot attend a particular function they can name an alternate employee to take their place.

We declare the foregoing information to be true and correct to the best of our knowledge. We hereby apply for Corporate Membership, and undertake, if admitted, to comply with the MIFT Constitution, Bye-laws, and the Code of Professional Conduct, and to pay the prescribed fees.

Name of Chief Executive / Director / Company Secretary

Designation

Fees

Send Cheque / Postal Order / Bank Draft (Please cross cheque / bank draft & make payable to "Malaysian Institute of Food Technology") of RM700 (include entrance fee RM500 & first annual subscription RM200)
Reference No.:
or
Transfer RM700 (include entrance fee RM500 & first annual subscription RM200) to "Malaysian Institute of Food Technology" at Malayan Banking Bhd. (or Maybank Bhd.), account no. 512-530-153-550.

Kindly email receipt / transaction slip with applicant's name included to This e-mail address is being protected from spambots. You need JavaScript enabled to view it or fax to 03-5631 1459

Membership approval is subjected to receipt of application fees.

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