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Member Application Form
Common Ground Mid Valley (CGMV) BO 1-C, Level 19 , Menara 2 No 3 Jalan Bangsar KL Eco City 59200, Kuala Lumpu
malaysiaGBC Industry & Institutional Member Application Form
1.1 Name of Company / Organization
1.2 Registered Under
i) Registrar of Company/SSM/ Societies
Yes
No
ii) Others /Act of Parliament
Yes
No
iii) Registration Number
Yes
No
If yes, please enter the Registration Number
1.3 Registered Address
*
1.4 Correspondence Address
*
15 Name of Director / Shareholders / Board Members
*
1.6 Contact Person (i)
i. Name
*
ii. Position
*
iii. Telephone / Mobile Phone No
*
iv. E-mail Address
*
1.7 Contact Person (ii)
i. Name
*
ii. Position
*
iii. Telephone / Mobile Phone No
*
iv. E-mail Address
*
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