Members or Distributors Application
Fields Indicated with * are Compulsory
1. Particulars of Applicant (Corporate)
Company Name *
Co. Reg. No. *
Street Name *
 
 
 
Postcode *
State *
Tel. No. (GL) *  Eg: 603XXXXXXXX
Fax No. *  Eg: 603XXXXXXXX
Email Address *
Application Type *   
2. Authorised Representative(s)
A. Authorised Representative
Salutation *
Name *
Position
I.C No./ Passport No. *
Street Name *
 
 
 
Postcode *
State *
Tel. No. (DL) *  Eg: 603XXXXXXXX
Fax No. *  Eg: 603XXXXXXXX
Email Address *
   
B. Alternate Authorised Representative
Salutation
Name
Position
I.C No./ Passport No.
Street Name
 
 
 
Postcode
State
Tel. No. (DL)  Eg: 603XXXXXXXX
Fax No.  Eg: 603XXXXXXXX
Email Address
3. Login Information
A. Authorised Representative
Member Id *
Password *
Confirm Password *
B.Alternate Authorised Representative
Member Id
Password
Confirm Password
4. Additional Information
Name of    *
Name of Contact Person *
Name of Authorised Rep *
Name of Alternate Authorised Rep
 
Terms and Conditions  of use for this system and relevant laws and rules issued by FIMM.

Member or Distributor Application (Documents Checklist)
Sel No Document
1 Board of Directors' Resolution approving the appointment of the AR
2 Certified true copy of relevant CMSL and approval that verify the eligibility of the applicant (if applicable)
3 Payment of application and annual fees
4 Printed online application