Registration Student Convo Student AlumniAlumni Life Time Membership + Free Card TNGRM100.00REGISTRATION FROM ALUMNIPERSONAL DETAILS * NAMA * I/C NOGENDERMALEFEMALE NATIONALITY MAILING ADDRESS (for postage) * E-MAIL * TEL (H/P) * DATE OF BIRTH* QUALIFICATION(S) OBTAINED FROM UTM ONLY:Select OptionDIPLOMAFIRST DEGREEMASTER DEGREEPhD * QUALIFICATION(S) OBTAINED FROM UTM ONLY: * COURSE AND YEAR OF GRADUATION QUALIFICATION(S) OBTAINED FROM OTHER INSTITUTION(S)Please state certificate/degree, institute/university and year obtained e.g. M.Sc (Themofluids) (Leeds) (2003)* Certification Graduation UTMDone(Use Cropper to set image and use mouse scroller for zoom image.)Done(Use Cropper to set image and use mouse scroller for zoom image.)Drop file here or click to select. * PasswordStrength: Very WeakEMPLOYMENT DETAILS POSITION/ JOB TITLE COMPANY NAME COMPANY ADDRESS COMPANY TEL NO* I AGREE TO BE MEMBER OF PAUTM AND AGREE TO ABIDE CONSTITUTION OF PAUTMYES (PAUTM's constitution at utmalumni.org.my/pautms-constitution/)NO* . My consent is given for PAUTM processes personal data in the following ways:- a). Processing of personal data with automatic equipment for Alumni Privilege Card PAUTM. b). Processing of personal data without using automatic equipment (non-automated processing/ PAUTM form).YESNO* PICTURE (WILL BE PRINTED ON THE CARD)Drop file here or click to select.* COLLECTIONSELF COLLECTION AT PAUTM OFFICE UTM KUALA LUMPUROR BY POS LAJU AND SERVICE ( Add RM8.00 SEMENANJUNG)OR BY POS LAJU AND SERVICE (Add RM13.00 SABAH SARAWAK)OR BY NORMAL STAMP POST (Add RM1.50) Select Your Payment GatewayHow you want to pay?Auto Debit PaymentManual PaymentPayment SummaryYour currently selected plan : , Plan Amount : Coupon Discount Amount : , Final Payable Amount: Submit
