ITSMF Thailand Membership Form

1. Membership Application Form
Website: http://www.itsmf.or.th/
Contact: membership@itsmf.or.th
To apply for membership in itSMF Thailand, please complete this form.
Mail application form and cheque to:
itSMF Thailand Association (TaxID: 3032751322)
2 St. Gabriel’s Foundation Building
Thonglor Soi 25, Sukhumvit Soi 55 (Thonglor)
Wattana, Bangkok 10110
All cheques to be crossed and made payable to:
“itSMF Thailand Association (
¢¡¤£¦¥¤¡¨§©¢¢ ©¤ ©¡ ©¢ !#%$ ('¢§)10
)”
Membership Enquiries: membership@itsmf.or.th
Kh. Viravan Tel: 08-1867-1441 • Fax: 02-736-3903
Membership Category
Please tick one of the options below to indicate desired membership category.
Category of Membership Annual Membership Fee
Student (requires current valid student-ID) THB 1,000.-
Individual THB 2,500.-
Organization5 THB 15,000.- for up to 5 employees
Organization10 THB 25,000.- for up to 10 employees
*Note: Please refer to itSMF Thailand website for a full description of membership benefits.
Method of Payment
All payments are to be made payable to “ITSMF Thailand Association (
¢¡¤£¦¥¤¡¨§©¢¢ ©¤ ©¡ ©¢
!#%$ ('¢§)10
)”. Please tick payment type from one of the below available options.
Payment Type Cheque/Bank Draft No. Bank Amount (THB)
Cheque Payment
Bank Draft
Cash
Bank Transfer
Bank: Bangkok Bank
Branch: Soi Ari
Acct.No: 127-4-75727-5
After making the payment through bank teller services (or ATM transfer), please scan in the
pay-in form (or ATM slip), and e-mail it to this address membership@itsmf.or.th
Terms and Conditions
(1) Payment must be made upon submission of application form.
(2) itSMF memberships will not be fully activated until full payment is received.
(3) Official receipt will be issued within 10 working days after payment.
(4) Members pledge to uphold and abide by itSMF Code of Ethics.
(5) itSMF reserves the right to reject any application for membership.

2. Membership Application Form
Website: http://www.itsmf.or.th/
Contact: membership@itsmf.or.th
Member Information
Please complete all requested information below in BLOCK LETTERS (incomplete
information may delay the processing of application).
Name (Mr. / Ms. / Mrs. / Prof. / Dr.):
Company:
Position / Title:
Office
Address:
Office Phone:
Office E-mail:
Mobile Phone:
Personal E-mail:
Areas of special interest (e.g., Service
Desk, Incident, Problem, Availability, etc.):
Current Certifications (e.g., ITSM,
CISA, CISM, CISSP, CPA, PMP, etc.)
*Note: For “Organization” memberships, please fill in one form for each registered employee.
Preferences:
Share my above provided information with Chapter’s other members.
I would like to receive itSMF circular e-mails.
Declaration: I, the above named applicant, declare that the information provided on this
application form is true and correct to the best of my knowledge.
____________________________
(please sign date here)
— For itSMF Use Only —
Received by ( date): Membership Approved
by ( date):
Membership Processed
by ( date):
Payment Received by
( date):
Membership Expiration
Date:
Membership No.:
Remarks: