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Application

Start your journey with ICDM.

1

Personal Information

2

Additional Details

Application Type*

Individual

Corporate

Salutation*

Full Name as per IC or Passport No. (if foreigner)*

Preferred Name*

Identification*

Passport Expiry Date

Date of Birth*

Contact No.*

Nationality*

Place of Birth*

Email Address*

Confirm Email Address*

Password*

Confirm Password*

Password must be at least 8 characters, consisting of symbol, number & uppercase and lowercase letter.

How did you hear about ICDM Membership?*

Are you a Reciprocal Member?*

Yes

No

IoD Country*

IoD Membership Certificate*

Supported format: .pdf .png .jpg .jpeg

Maximum Size: 5MB

Membership Category*

Corporate Membership Category*

Application Type*

1-Year Plan (standard)

2-Year Plan (standard)

3-Year Plan (15% saving)

5-Year Plan (20% saving)

Lifetime Limited (15 years)

Application Type*

1-Year Plan (standard)

2-Year Plan (standard)

3-Year Plan (15% saving)

5-Year Plan (20% saving)

Lifetime Membership

Upload CV*

Supported format: .pdf .doc .docx

Maximum Size: 2MB

Current/Last Working Experience

Company Name*

Type*

Industry*

• Sub Industry description will display here.

Designation*

Position*

Year Start*

Still current/ Present

Year End*

Board Experience

Company Name*

Type*

Industry*

• Sub Industry description will display here.

Board Company Website*

Designation*

I confirm that the private company I served as a board director met the RM 3 mil annual revenue requirement at the time of the membership application / while I was a company director.*

Year Start*

Still current/ Present

Year End*

Board Role*

Correspondence Address

street 1*

street 2

city*

Postcode*

Country*

Where are you currently working?*

Corporate Information

Organisation name*

Type of Organisation*

Non-PLC

GLIC

PLC

Business Registration No*

Company TIN No.*

Industry*

• Sub Industry description will display here.

CEO Information

CEO Name*

CEO Designation*

CEO Phone Number*

CEO Email Address*

Upload SSM Document

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Maximum Size: 5MB

Upload documents (multiple documents - only appear for Affiliate category)

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Maximum Size: 5MB per file

You can select multiple files

Corporate Address

Business Registered address*

City*

Postal Code*

State*

Country*

Declaration, Undertaking, Authorisation

The company hereby applies for membership of the ICDM and the company irrevocably agrees to be bound by the Rules of the ICDM and all rules and regulations made under it from time to time. The company has sought confirmation from the respective directors of the company and confirms that:

its directors has not been disqualified (by court order or voluntary undertaking) from being a director of any company, nor is the company aware of any circumstances which may lead to such disqualifications;
the directors of the company do not have any criminal convictions (other than compounds for traffic offences);
it does not have any directors who is an undischarged bankrupt nor is the company aware of any circumstances that may lead to bankruptcy proceedings being brought against any of its directors; and

The company hereby undertakes in itself and undertakes to ensure and procure each of its directors:

to comply with, where applicable, the Rules of ICDM, ICDM Members' By-Laws and all rules and regulations made by ICDM from time to time;
to conduct itself, both publicly and privately, in a professional manner and so as to uphold the ICDM's reputation as stipulated in ICDM Code of Conduct; and
not to represent publicly the views of the ICDM or to claim support, without the consent of the Board (or of an officer or employee of the ICDM nominated by the Board for such purpose).

The company hereby give consent:

to allow ICDM to feature the company name & company logo on the ICDM website and any other communication channels to indicate that the company is ICDM Corporate Member.

The company hereby warrants and undertakes to ICDM that:

it will procure its authorised representative to create an account in the ICDM+ Portal for and on behalf of the company and for each of its directors, and to update the provided information (eg. any changes in the composition of its board) within thirty (30) days from the effective date of such change, for the purposes set out under the ICDM Website & Portal Terms of Use;
it will ensure that the information uploaded onto ICDM+ Portal is current and accurate;
it will ensure and procure each of its directors to submit a copy of their most recent CV through the ICDM+ Portal within [thirty (30) days] from the submission of this application.
it will, where reasonably possible, ensure its directors are aware of and will comply with the applicable provisions set out under the ICDM Website & Portal Terms of Use;
the company has provided a copy of ICDM's Privacy Policy at www.icdm.com.my/privacy, as revised and updated, to its authorised representative and has procured the individual's (and directors, where applicable) consent to provide his/her personal data to ICDM for the purposes set out under ICDM's Privacy Policy; and
any changes to the ICDM Website & Portal Terms of Use and/or Privacy Policy, will reflected on the ICDM Website. Continued usage of the service will signify that the company agrees to, and request for its directors to agree to, any such changes.

I agree to accept the Terms Of Use and Privacy Policy of ICDM.

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