MMLHS Membership Application Form
MMLHS Membership Registration Form
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Salutation
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PROF DR.
ASSOC PROF DR.
DR.
MR.
MS.
DATUK
DATO'
DATIN
Full Name
Malaysian ID/IC Number/ Passport No.
Phone
Email
Region of Workplace
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East Coast
Central Region
Northern Region
Southern
Sabah/Sarawak/Labuan
Position
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Hematopathologist
Hematologist
Specialist (Other field)
Medical Lecturer
Medical Officer/Trainee
Medical Laboratory Scientist
Medical Laboratory Technologist
Laboratory Manager/Executive
Sales Rep/Executive/Apps Specialist
Others
Institution/Hospital/Company
Payment Item
Life Member for Specialist
Life Member for MLS/SO
Life Member for MLT
Annual Member [Flat Rate for All Category]
Corporate Member
Payment Item
Online Banking (No Additional Charge)
Credit Card (RM15 Charge)
Payment Method
Pay with Billplz (Online Banking)
Pay with Card (Stripe)
Pay with Card (Stripe)
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