62A, Jalan BP7/8, Bandar Bukit Puchong, Selangor.

  secretariat@mysir.org   Login / Register

MEMBERSHIP


Membership
Registration

Header
1. PERSONAL INFORMATION

Please Enter Title, First / Last Name.
Please Enter valid IC / Passport.
Please Enter Valid Email.
Please enter login password
Please confirm password.
Please Enter Date Of Birth.
Please Select Nationality.
Please Select Gender.
Please Enter MMC No.
Please Enter Home Address.
Please Enter Postcode.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Fax No.
Please Enter Institution.
Please Enter Department.
Please Enter Work Address.
Please Select Mailing Address.
Please Enter Present Position.
Please Enter Present Activities.
2. REFERENCES

Candidates are required to have two referees who are members of the MYSIR. The referees should be members in good standing.

Reference One

Please Enter Title, First / Last Name.
Please Enter Work Address.
Please Enter Postcode.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Fax No.
Please Enter Email.

Reference Two

Please Enter Title, First / Last Name.
Please Enter Work Address.
Please Enter Postcode.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Fax No.
Please Enter Email.
3. ACCREDITATION FOR APPROPRIATE REGION

Click on the name(s) to select:

Please Enter Other Region.
Please Enter Certifying Agency.
Please Enter Certification Date.
4. MEMBERSHIP IN COLLEGE OF RADIOLOGY

Please Select
5. DIAGNOSTIC RADIOLOGY TRAINING

Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
6. INTERVENTIONAL RADIOLOGY / NEURO INTERVENTIONAL RADIOLOGY / OTHER TRAINING
FIRST YEAR
Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
SECOND YEAR
Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
THIRD YEAR
Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
ADDITIONAL TRAINING
Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
7. OVERSEAS TRAINING IN INTERVENTIONAL RADIOLOGY

Please Select Training Duration.
Please Enter Institution.
Please Enter Director of Training.
Please Enter Address.
Please Enter Phone No.
Please Enter Mobile No.
Please Enter Email.
8. MEMBERSHIP & PAYMENT

Ordinary members
Entrance Fee – RM 300.00
Annual Subscription Fee – RM 250.00

Life members
Entrance Fee – RM 0.00
Single Payment – RM 5000.00

Junior members
Entrance Fee – RM 150.00
Annual Subscription Fee – RM 150.00

Associate members
Entrance Fee – RM 70.00
Annual Subscription Fee – RM 70.00

Please Select
Please Select
Please Upload Payment Proof

Cheque: Payable to "Malaysian Society of Interventional Radiology".

Invitation Code: