Membership Form

Membership SignUp

Mr.
Ms.
*Last Name :
*First Name :
*Middle Name :
*Company Name :
*Title/Designation :

Business Address :

Office/Building :
Street :
City/Province :
Country :
Zip Code :

Country Code – Area Code – Number

*Business Tel. Nos. :

Fax No.:
Mobile Number :
*Email :
Date of Birth :

Education

(Check the highest level of attainment)

High School
Bachelor’s Degree
Master’s Degree
Doctorate
Associate’s

Professional Certifications (i.e. C.P.M, A.P.P., CPIM, CIRM. Please list others)
Please describe your major job function / responsibility

PASIA Committee

Please check which PASIA Committee you would like to be involved in :

Training and Seminars
PASIA Magazine and Publications
Regional Procurement Conference
Other Events
Membership
I would like to be a member of PASIA, but not yet fully available to participate in the committee.