Name:  *required

Passport No. :

Identity Card No.

Date of Birth :

Address in Malaysia:

Address in Ukraine:

Phone: *required

Email:  *required

Message:

I hereby apply for admission to be member of MCA Overseas club Ukraine. I declare that I am not less than 18 years of age and that I am a Malaysian Citizen. I subscribe to the objectives of Malaysian Chinese Association agree to be bounded by the provisions of the Constitution of the Association. I hereby also declare that the particulars given above by me are true and correct.

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