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NAME :

Username

Password

Telephone

Emergency Contact Name

Emergency Phone No.

Date of birth

Gender

Identity Card/Passport No.

Nationality

Company

Address

Zip Code

City

State

Country

For Year

Filled by

State Association

Club

Applicant

State Association Memberships Number (If Any)

Role

Category

TEAM / CLUB :

Upload Applicant Passport-Size Photo

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Fees Payment

MAKE PAYMENT (CLICK BELOW)

OR TRANSFER TO

Bank Details & Fees

Bank	: HONG LEONG BANK BERHAD
Name	: PERSEKUTUAN KEBANGSAAN BERBASIKAL MALAYSIA
Account No.	: 026-000-27034

PLEASE TAP THE BUTTON SIGN UP AFTER MAKE THE PAYMENT.

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By uploading, you certify that you have the right to distribute this image.

Fees

Category	Fee (RM)	Remark
Individu	80.00
Member of State Association (Affiliate)	60.00	Applicant must be a member of state cycling (Check HERE)
Foreigners	150.00	Non Malaysian Citizen
UCI Commissairie	300.00	UCI Certified Commissire
National Commissaire	60.00	MNCF Certified Commisaire
Continental Team	300.00	Continental Registered to UCI
Para Cycling	60.00

If having difficulty, please email your application, photo & identity copy to ucilicense.mncf@gmail.com

*Licence valid from 1st January 2023 – 31st December 2023.
*Licence process will take 1 month after received
*Please refer to state cycling secretary for endorsement here.

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