Home > Students & Education > Re-Registrations of Student > Online Forms (Students) Updated: 11/05/2017
Online Application for Re-Registration as Student (Page 1 of 2)  print
The online form will prompt you to two (2) pages
Please use these forms to provide MAICSA with information to support your application
Please use the EDIT button at the bottom of the screen to key in the information
When you have completed the forms, please use the PRINT button at the bottom of the screen to print out the information that you have keyed in or click on the SAVE button at the bottom of the screen to save the data
The saved data will be purged from the MAICSA Interactive after one (1) month
Click on the SAVE button and NEXT button at the bottom of the screen to continue next page
Students are required to submit the hardcopies (page 1-2) of the application form together with the supporting documents, within one (1) month to the Institute, failing which, the submission will be invalid.
Reference No.: 7380276736
The Malaysian Institute of
Chartered Secretaries and Administrators
(MAICSA)

Bangunan MAICSA, No. 57, The Boulevard, Mid Valley City,
Lingkaran Syed Putra, 59200 Kuala Lumpur.
Tel: 03-2282 9276   Fax: 03-2282 9281
Homepage: www.maicsa.org.my   E-mail: students@maicsa.org.my
APPLICATION FOR RE-REGISTRATION AS STUDENT
To: Council of The Institute of Chartered Secretaries and Administrators

I apply for re-registration as a student of The Institute of Chartered Secretaries and Administrators and undertake to comply with the regulations relating to students of The Institute. I certify that the information given here is to the best of my knowledge accurate in all respects.
 
   
Name (in block letters) Signature and Date
The fees payable on re-registration is enclosed:
STUDENT RE-REGISTRATION (1 YEAR)
Fees enclosed by Cheque / Bank Draft numbered    Bank  
Date of first registration :
Date of re-registration (if any) :
Student registration number :

Please complete ALL SECTIONS in BLOCK CAPITALS:

Payment Details:

Cheque / bank draft / m.o no  for amount RM  made payable to "MAICSA" or # Please charge RM  to my credit card:
Please tick accordingly    Visa    Mastercard   Bank   Card No:
Name on the card  Expiry Date
PERSONAL PARTICULARS
Name :
( / / )
Mailing Address :
Email Address :
Telephone No. :   Sex:   Age:
NRIC :   Date of Birth:
 
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