INSTITUT RIMBAWAN MALAYSIA 
Institute of Foresters Malaysia
(Inaugurated on 3rd Feb. 1979; approved by the Registrar of Societies Malaysia on 2nd August 1980)
 
APPLICATION FOR MEMBERSHIP

   

Setiausaha,  
Institut Rimbawan Malaysia,  


   

  
  
I apply to be admitted as a member of the Institute of Foresters Malaysia. I declare that the particulars given in this application form are true and complete. I am aware that should any of the particulars given here be found to be false, my application/membership shall immediately be cancelled.  

  
I append  
  
(a) A copy of my original certificate of basic education/qualification in forestry. 
(b) A copy of my birth certificate. 
(c) A copy of my citizenship certificate. 
(d) Two (2) recent identity card-sized photographs of myself.
(e) The registration fee of (*Delete if not applicable) 
Ordinary member : RM100.00  
  

Associate member : RM50.00  
  

Student member : RM10.00  
 
                                                                     
…………………………………                                                                    Date : ……………………………  
Usual signature of applicant 
 
I. PERSONAL PARTICULARS
 
1. Grade of membership applied for  
2. Name in full  
3. Identity card no.  
4. Office address  
5. Telephone no.  
6. Home address  
7. Telephone no  
8. Place of birth     9. Date of birth  
10. Sex          
11. Citizenship     12. Race  
13. Public honours (decorations, etc.)  
  
 
II. EDUCATION 
 
14. Basic education 
 
Name of school/institution
Period of attendance
Examination and grade passed
     
     
     
     
     
  
 
15. Higher education
 
(a) Graduate studies (State degree/diploma obtained with class of honours and year of graduation) 
 
Name of institution
Year
Field of study
Degree/diploma
       
       
       
       
       
 
(b) Post-graduate studies
 
Name of institution
Year
Field of study
Degree/diploma
       
       
       
       
       
 
III. PROFESSIONAL QUALIFICATIONS
 
16. Membership to profesional organisations 
 
Name of professional organisation
Grade of membership
Date of admission
     
     
     
     
     
 
IV. EXPERIENCE 
 
17. Present position
 
Position
Employer
Period
Nature of duties
       
       
       
       
       
  
 
18. Previous positions
 
  
Position
Employer
Period
     
     
     
     
     
 
 
V. OTHER RELEVANT INFORMATION 
 
19. List of theses produced, publications and any other relevant information i.e. consultancies, invited lectures delivered, etc.
 
 
 
 
 
 
 
 
 
 
 
   
(If space is insufficient, additional information may be typewritten on a separate sheet).
 
VI. REFERENCES 
 
20. Give the names of two persons, preferably professional foresters in responsible positions, who are able and willing to reply to the Institute’s enquiries concerning you. One of them should have been immediately responsible for your recent work. Collectively the two persons should be able to reply to enquiries concerning your carrier since graduation. No person should be named without his express permission.
 
Name (Capital letters)
Designation
Address
Period known to applicant
       
       
       
       
       
 
 
21. Recommendation by two registered members of the Institute of Foresters Malaysia.
 
  
We the undersigned, being registered members of Institute of Foresters, Malaysia, hereby recommend the admission of .........................................  ......................................................(name of applicant)  
as a ..........................................................(Type of membership) member of the Institute Foresters Malaysia.  
 
 
 
Proposer
Seconder
Name in full (block capitals)    
Address    
Type of membership    
Membership no.    
Signature    
Date    
 
(For office use only)
 
1. Date application received  
2. Membership grade applied for  
3. Application number  
4. Payment received (a)   Amount  
    (b) Type of payment * Cash  
        * Money order/Bank draft no.  
        * Cheque no.  
5. (Reference to referees provided, if necessary)  
    (a) Date of reference  
    (b) Date reply received  
6. Date application considered by Council  
7. Decision of Council (a) Application approved/rejected*  
    (b) Reason application rejected  
    (c) Membership grade approved  
    (d) Membership no.  
8. Date of application informed  
(*Delete if not applicable)
 

IRIM 2004