✍️ Professional Onboarding Form

Apply for MCSA Licensure

Submit your credentials, experience, and training certificates to join the MCSA active caregiver registry.

1. Identity & Contact Details

Full Name

Email Address

Phone Number (e.g., 012-3456789)

Primary Location (Town, State)

NRIC / ID Number (Required for Tax Receipts)

2. Caregiver Accreditation Details

Specialized Care Categories (Select all that apply)

🍼

Confinement Lady

Confinement Care

🏥

Patient Companion

👴

Elderly Caregiver

💪

Rehab Assistant

Rehabilitation Care Assistant

👶

Babysitter Service

Years of Experience

Professional Bio & Care Specialties

3. Upload Professional Headshot

PREVIEW

Profile image file:

Please select a clear portrait profile image (JPG, PNG formats, Max 5MB):📁 Choose Profile Photo

4. Credentials & Diagnostics Attachments

Professional Certification FileSelect Certificate FilePDF, JPG, PNG (Max 5MB)

TB & Medical Clearance RecordSelect Health DiagnosticsPDF, JPG, PNG (Max 5MB)

NRIC / IC Card Front & Back Photo or Copy (.pdf/.jpg/.png) - Required for safety verificationSelect IC/NRIC DocumentPDF, JPG, PNG (Max 5MB)

Licensure Fee Requirement: Submitting this registration queues you in the vetting list. Once the admin audits your files and details, approval generates a membership ID. A RM350 annual licensing fee is billed upon card issuance.