-- AKARD AWARD APPLICATION FORM

Based on 2025 FYP as at 31st December 2025

NAMLIFA Member Verification

Please enter your NRIC to verify your membership

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Format: 123456-12-1234 (Enter 12 digits only)

Having trouble verifying your membership?

Please contact NAMLIFA office: 03-9281 3167

SECTION A: Personal Details

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IMPORTANT NOTE: APPLICANT MUST BE A MEMBER OF NAMLIFA AS AT APRIL 30th 2026 AND DUES FOR 2025 AND 2026 DULY PAID

Membership Details

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Click to upload photo (Required)

Max file size: 10MB • Accepted formats: JPG, PNG, JPEG

To be used for AKARD recognition & AKARD advertisement

* Required

Personal Information

Company & Agency Details

Award Collection & Declaration

Important Notes:

  • * If not attending the event, we kindly request a payment of MYR50 to cover the handling & courier fees for the award to be delivered to your correspondence address.
  • * We follow your AKARD Recognition based on your above choice. Kindly inform us as per below to prevent last minute changes:
    • 1) Sabah, Miri & Kuching - 2 months earlier
    • 2) Other Branches - 1 month earlier
ANSWER REQUIRED ON THE FOLLOWING QUESTIONS BY SELECTING THE OPTIONS

1) Has any complaint or proceeding of any nature, that has not already been fully reported to or acknowledged by NAMLIFA, ever been brought against you by or through any insurance association, or by or through any government body or representative thereof, or alleging you committed a felony, whether related to insurance or not? *If yes, include complete document.

AKARD Life Member Qualification

SECTION B: AKARD Award Selection

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SECTION C: Payment Information

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DECLARATION

  1. I confirm that all information given is true and complete. I hereby authorise NAMLIFA to verify the information from whatever source, and by whatever means that NAMLIFA considers appropriate.
  2. If any information is subsequently found to be inaccurate and has contributed to the organisers being misled into accepting this application, NAMLIFA reserves the right to retract the recognition.
  3. I confirm that I shall be subject to the terms and conditions governing the application of NAMLIFA AKARD membership and shall indemnify NAMLIFA against any claims and liabilities.
  4. I understand that NAMLIFA reserves the right to decline an application without giving any reason.
  5. Any broken plaques/awards may be replaced for a fee of RM 200 per piece. (All broken plaques/awards must be returned before replacements are processed).
  6. I undertake to keep the plaque/award for my own purposes and not to sell, lend or give it to anyone else.
  7. NAMLIFA reserves the right to change the venue or date of the Annual Award Dinner if necessary, without prior notice.
  8. I agree that my signing on the NAMLIFA AKARD application form, shall constitute my acceptance of and my agreement to be bound by the terms and conditions contained in this form.
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