Registration Request Form

First Name (required)

Last Name (required)

Your Email (required)

Contact Number

Select Membership Type (required)
Geek: MYR 150/year

Account holder: MDA Design Centre
Account number: 8008 33 46 33
Bank name: CIMB Bank
Bank branch: 138, Jalan Burhannuddin Helmi, Taman Tun Dr. Ismail, 60000
Kuala Lumpur, Wilayah Persekutuan, Malaysia.
SWIFT: CIBBMYKL

Membership Fee Bank Transaction Receipt (required)
*Max File Size [2MB]
*accepted file types: jpg, pdf

Additional Message

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