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Penang English Language Learning &Teaching Association

Membership

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Sign up and be a member of PELLTA now. Just complete the membership form below and mail it off to the stated addressed, accompanied by payment.

 

               

Persatuan Pembelajaran-Pengajaran Bahasa Inggeris Pulau Pinang

(Penang English Language Learning and Teaching Association)

Blok 107-16-05, Gambir Heights, Pesiaran Bukit Gambir 1, 11700 Penang.

e-mail : pelltapenang@yahoo.com

_________________________________________________________________________________________

The Treasurer,

PELLTA,

2351 Lengkok Sungai Gelugor 2,

11700 Gelugor, Penang

 APPLICATION FOR MEMBERSHIP/ RENEWAL OF MEMBERSHIP

FOR CALENDAR YEAR 200__

 Please     :- I wish to  ......  join PELLTA  ......  renew my membership

 Payment enclosed :-   ..... RM 15.00 for new membership

                                     (Entrance Fee RM 5.00 + Annual Subs. RM 10.00]

                                     ..... RM 10.00 as annual subs. for membership renewal

 Please circle :- CASH / P.O. /M.O. /CHEQUE No. ___________________________

 (All postal order/money order/cheques should be crossed and made payable to PELLTA. For outstation cheques, kindly include an additional $0.50 for bank charges.)

 Full Name (Mr/Mrs/Ms)   : __________________________________________________________

Home Address                   : __________________________________________________________

                                            __________________________________________________________

Postcode                           : ___________________  Tel:________________________

E-Mail                                : _____________________________  H/P _______________________

 

 School/Institution            : __________________________________________________________

                                            __________________________________________________________

                                            __________________________________________________________

                                            Postcode: ___________________  Tel: ________________________

 Note:- All subscriptions & memberships expire on 31st December regardless of the date of application.

 

 

Date: _________________                                                 Signature: ______________________

 

 For Office Use Only

 Membership No : _____________    Receipt No.: _______________   Issued on_______________

Paid by CASH/CHEQUE/P.O./M.O No: __________________ for RM _____________

Comments: ___________________________________________________________________________