NETWORKING FOR STRONGER PORT INDUSTRY AND BETTER COMMUNITY

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APPLICATION FORM FOR REGULAR MEMBERSHIP

Please fill in this form in capital letters, all information on this form will only be used for the purpose of APSN.

PERSONAL INFORMATION

Photo

Title

Name (FN, MN, LN)

Gender

Date of Birth( DD/MM/YYYY)

E-mail

Tel

Mobile(If available)

Fax

Postal Address

ORGANIZATION INFORMATION

Name

Department / Division

Position

Website

GENERAL QUESTIONS

How do you know us

You’d like to share the above information with

PERSONAL PROFILE

Including but not limited to the education background, work experience, major concerns, major achievements, etc.

I hereby apply for regular membership of APEC Port Services Network (APSN) and agree to abide by its rules and regulations.

I certify that the statements made in this application are true and correct to the best of our knowledge and belief.

Signature:
Date (DD/MM/YY):

REGISTER

Email (This email will serve as a login account)

Enter Password

Confirm Password

Verification Code

CONFIRM
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