Life Membership Registration
All registration and renewal procedures can be now done online. We accept online payment.
Personal Information
Full Name
*
Gender
*
Select Gender
Male
Female
Email
*
Date of Birth
*
IC Number (Without -)
*
Phone Number
*
Postal Address
*
MAHPC Information
Do you have a valid MAHPC annual practicing license?
*
Select
Yes
No
Registeration Number
MAHPC Certification
Choose File
Education Information
Level of Education
*
Select Education
Diploma
Advance Diploma
Bachelor Degree
Master
PhD
Academic Qualification
*
Academic Certification
*
Choose File
Work Information
Workplace
*
Position
*
Sector
*
Select Sector
Government
Non-Government Organization (NGO)
Private
University
Freelance/Self-Employed
Unemployed
States
*
Johor
Kedah
Kelantan
Kuala Lumpur
Labuan
Melaka
Negeri Sembilan
Pahang
Penang
Perak
Perlis
Putrajaya
Sabah
Sarawak
Selangor
Terengganu
Area of Specialty
*
Pediatric
Vocational, Work, and Driving
Mental Health
Hand and Upper Limb
Geriatric and Age Care
Neurology Rehabilitation
Burn Rehabilitation
Cardiac Rehabilitation
Assistive Technology
Palliative Care
Neurodevelopmental
Community Service
School Based
Special Education
Public Health Care
Pain
Ergonomics
Caregiver Training and Support
Wheelchair
Visual Impairment
Other
Please State
Listing in Directory
*
Do you want to be listed in directory?
Select
Yes
No
Create Member Account
Username
*
Password
*
Avatar
*
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