Registration Form

New Registration Form

Membership Type

Member Details

Primary Member Name

Company Name

Mobile Number

Email Address

Passport Number

Residence Address (Local)

Visa Type

Spouse Details

Spouse Name

Spouse Mobile Number

Spouse Email Address

Spouse Passport Number

Spouse Visa Type

Children Details

Number of Children

Payment Details

Note: Make out your cheque for the Fees to “KELAB BHARAT KUALA LUMPUR” and deposit to any RHB cheque deposit machines or make an online transfer as per following bank account and bank details:

Beneficiary Name: Kelab Bharat Kuala Lumpur

Beneficiary A/C No : 21427700086170 (Current account)

Beneficiary Bank Name: RHB Bank

Amount (RM)

Bank Name

Payment Date

Payment Reference Number

Referred By

Attachment