PERTUBUHAN SISTEM PENGANGKUTAN PINTAR MALAYSIA

INTELLIGENT TRANSPORT SYSTEM ASSOCIATION OF MALAYSIA (ITS MALAYSIA)

Registered address: Highway Planning Unit, Level 2, Block A, Ministry of Works, Malaysia,
J alan Sultan Salahuddin, 50582 Kuala Lumpur
Tel: 03 2771 4201 Fax: 03 2711 3975

APPLICATION GUIDE FOR ELECTION AS MEMBER

Guidelines for applicant:

Please complete the required particulars in the form. This form can be typed or handwritten.
Applicants for Ordinary / Life / Associate membership are not required to complete Item 3.
Applicants for Corporate membership are only required to complete Items 3, 7, 8 and 9.

Membership Grades:

a. Ordinary Membership
A person who has the interest or experience or practice in any of the field of land transport, ITS
sectors, information and communication technology sector or road engineering related field and like
to be actively involved in the promoting of science and practice of ITS.

b. Corporate Membership
A professional institution, association, firm, company, organisation or other similar body whose
activities include the science and practice of road engineering or land transport, ITS sectors,
information and communication technology sector as well as other transport related professional
commercial activities.

c. Life Membership
A person who has the interest or experience or practice in any of the field of land transport, ITS
sectors, information and communication technology sector or road engineering related field and like
to be actively involved in the promoting of science and practice of ITS or any elected ordinary
member by payment of an up-front fee.

d. Associate Membership
A person who is keenly interested in the science and practice of road engineering but is not
eligible for election to other grades of membership.

e. Honorary Membership
A person of outstanding eminence and long experience in the science and practice of some phase
of road engineering or land transport sector and has contributed outstanding services to ITS Malaysia
may be elected to Honorary Membership by the recommendation of the Council and approval by
members carrying a simple majority vote by ballot or show of hands. Each Honorary Member shall be
entitled to all rights and privilege in ITS Malaysia except the right to vote and hold office in the
Association.

f. Membership Fee
New ITS Malaysia members are required to pay the entrance and annual subscription fee for the
first year and annual subscription fee for subsequent years.






APPLICATION FOR ELECTION AS MEMBER OF ITS MALAYSIA


Type of Application: New Renewal
I / We wish to apply to be elected as _________________ Member (Ordinary / Corporate / Life / Associate)

1. PERSONAL PARTICULARS (for Ordinary / Life / Associate membership)
i. Name in full: (Mr./Mrs./ Ms./ Ir./ Dr./ Others) ________________________________________________________________________
(please use block letters)
ii. Postal address: ______________________________________________________________________________________________
______________________________________________________________________________________________
(Note: Any change in address must be notified promptly)
iii. Telephone no.: Residence: _____________________ Office: _____________________ Hand phone: ______________________
Fax: ___________________________ Email: _______________________________________________________
iv. Place of Birth: _________________________________ Date of Birth: ________________________ Age: _____________________
v. Nationality: ____________________________________ Identity Card No.: ______________________________________________


2. PRESENT POSITION
i. Name of employer: ____________________________________________________________________________________________
ii. Address: ____________________________________________________________________________________________________
iii. Designation: ______________________________________________________ Date of appointment: _________________________


3. PARTICULARS OF ORGANISATION / INSTITUTION (for Corporate membership)
i. Organisation / Institution: _______________________________________________________________________________________
ii. Address: ____________________________________________________________________________________________________
___________________________________________________________________________________________________
iii. Contact person: ______________________________________________ Designation:_____________________________________
iv. Telephone no.: __________________ Fax no.: _____________________ v. Email: _______________________________________


4. ACADEMIC ACHIEVEMENT

5. Engineering Discipline: (Civil / Mechanical / Electrical / Others ) ______________________________________________________
6. Non Engineering Discipline: _________________________________________________________________________________
7. Membership of Other Engineering and Scientific Bodies: ____________________________________________________________
8. Honours, Decorations and Awards: _____________________________________________________________________________

9. UNDERTAKING TO BE SIGNED BY APPLICANT

I / We, the undersigned, do hereby agree that, in the event of my / our election, I / we will be governed by the ITS
Malaysia Constitution for the time being in force and that I / we will accept as final and binding the decisions of the Council
on all matters dealt with by them in accordance with the provisions of the said constitution.
I / We further undertake that I / we will promote the objectives of ITS Malaysia as far as may be in my / our power,
provided that whenever I / we shall signify in writing to the Honorary Secretary General of my / our intention to resign I /
we shall after the payment of any arrears, which may be due from me / us at the period, be free from this obligation.
I / We accept responsibility for the accuracy of the particulars contained in this application form and agree that if I / we, am
/ are elected, the validity of my / our election shall depend upon the accuracy of such particulars as required by the
Constitution of ITS Malaysia.


Signature of Applicant: ________________________________ Date: ____________________


10. PAYMENT

Cheque No. / Cash: ______________________ for RM __________________ in favour of ITS Malaysia is enclosed herewith.

By Credit Card
Please charge RM ______________________ to my credit card. Visa Mastercard
Credit Card Number: ____________________________________________________ Expiry Date: _____________________
Card Holder: _______________________________________ Signature: _____________________ Date: _______________