Membership Application Form

Required documents:

  1. Photocopy of Business Registration Certificate / Certificate of Incorporation / Form 49
  2. Photographs of Factory (Exterior / Interior)

 

Fees:

Turnover (RM) Entrance Fee (RM) Annual Fee (RM)
15 mil. 2,500 2,500
15 mil. ~ 50 mil. 5,000
Above 50 mil. 7,500

Please issue payment to "Malaysian Organisation of Pharmaceutical Industries" upon approval.

We, hereby apply to become a Member of the Malaysian Organisation of Pharmaceutical Industries (MOPI) and, if elected, agree to be bound by the Memorandum & Articles of Association and Rules of the Organisation for the time being in force.

Applicant to submit online or fax the membership form (to MOPI Secretariat) need to send required documents by POST to support their application in order for approval.

Generated with Mad4Joomla Mailforms Version 1.2
* Required information.
Business Name *
Business Address
Head Office
Address
Tel
Fax
Factory
Address
Tel
Fax
Official Email
Web Page
Business Registration No / Certificate of Incorporation No *
Manufacturing License No: D.C.A *
I.C.A.
Name of Constitution *
Percentage of Ownership (For Join Venture only)
Malaysian %
Foreign %
Does your company have any pharmaceutical subsidiaries / affiliate company overs
If yes, which country(ies)?
Authorized Capital (RM) *
Paid-up Capital (RM) *
Revenue for Year
Revenue Amount (RM) *
Name of CEO / MD *
1.Name Directors / Partners
1.Email of Directors / Partners
2.Name of Directors / Partners
2.Email of Directors / Partners
3.Name of Directors / Partners
3.Email of Directors / Partners
4.Name of Directors / Partners
4.Email of Directors / Partners
5.Name of Directors / Partners
5.Email of Directors / Partners
6.Name of Directors / Partners
6.Email of Directors / Partners
Type of products manufactured by your company in Malaysia *
Others, please specify
Pharmaceutical dosage forms manufactured by your company in Malaysia *
Others, please specify
Manufacturing Area (sq. ft.)
Q.C Area (sq. ft.)
Administration Area (sq. ft.)
Store Area (sq. ft.)
Name of Pharmacist
Reg No.
Type of Poisons Licence Issued & No.
Type of Poisons Licence Issued
Staff Strength
Administration
Production
Engineering
R & D
QA
QC
Sales
Proposed By (Currently a member of MOPI)
Seconded By (Currently a member of MOPI)

Hover over the left image and enter the security code into the right textfield.
Copyright © 2017 The Malaysian Organisation of Pharmaceutical Industries. All Rights Reserved.
Powered by Netxtreme Onesolution Sdn Bhd