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Corporate Membership Application

Membership Type Entrance Fee * Annual Subscription*  
$ 535.00 $ 214.00  
Special Promotions
Waiver of membership entrance fee ($500) * $ 428.00 No complimentary membership
* $ 642.00 1 year complimentary
(4th year)
* $ 1070.00 2 years complimentary
(6th & 7th year)
* $ 1498.00 3 years complimentary
(8th, 9th & 10th year)
* All the above fees are inclusive of GST and are subjected to a one-time full payment.
Company *
Business Registration No *
Address *
Postal Code *
Contact No.  * (Company Tel)

 * (Company Fax)
Email *
Capital Structure *
Number of Employees *
Number of Supervisory &
Managerial Staff
Annual Sales Turnover
(last fiscal year)
Industry *

Please tick one box above and specify trade :
Name of the person who will represent your company at MDIS meetings and with whom to liaise on all matters:
1st Representative
Name *
Position *
Email *
2nd Representative
Name *
Position *
Email *
How did you first come to know about MDIS? :

MDIS values your privacy and we are committed to safeguarding your personal data in compliance with the Personal Data Protection Act 2012. By providing your personal details, you have authorised MDIS to share with you our marketing, advertising and promotional materials.

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Phone call
Cheque Number (By Mail)
Credit Card Holder Name
Card Number
Expiry Date  / 
* Mandatory fields
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