Student Membership Registration  
* indicates a required field

Student Membership Information

First Name *
Last Name *
IC / Passport No *
Date of Birth *
Select a date from the calendar.
e.g. 31/12/1970
Gender *
Race *
Nationality *
E-Mail *
Alternative E-Mail *
Phone No *

Additional Information

Note: This information will be used to obtain MSTB approval.
Matriculation No
Current CGPA
Current Level of Education
Current University

Current Institute/University
Current Field of Study
   

Correspondence Information

Address *
City
State *
ZIP/Postal Code *
Country *
Where did you learn about Q-Portal *
   

Declaration of Personal Data Protection Act (PDPA)

Please tick (✓) in the appropriate boxes
(* Compulsory and necessary for successful registration)
* I/We have read and agree to the Terms and Conditions, and Statement of Privacy.
Saya/Kami telah membaca dan bersetuju dengan Syarat-syarat dan Peraturan(versi bahasa inggeris) serta Kenyataan Privasi.
* I/We hereby give my/our consent for MSTB to retain information provided in this form for the purpose of registration and communications related to my membership to Q-Portal.
Saya/Kami dengan ini membenarkan MSTB untuk meyimpan maklumat yang dinyatakan di dalam borang ini untuk tujuan pendaftaran dan komunikasi berkaitan keahlian Q-Portal.
I/We hereby give my/our consent for MSTB and/or its appointed agent to contact me/us for the purposes of providing update on and/or invitation to participate in future activities that may be of interest to me/us.
Saya/Kami dengan ini membenarkan MSTB dan/atau ejen dilantik untuk menghubungi kami untuk mengemaskini maklumat dan/atau menyampaikan undangan untuk aktiviti-aktiviti di masa hadapan yang mungkin bersesuaian dengan saya/kami.

Should you wish to cease receiving such communications, please inform MSTB through email: info@mstb.org.
Sekiranya anda tidak lagi berhasrat untuk menerima sebarang komunikasi, anda boleh menghubungi MSTB melalui emel: info@mstb.org.