JUNIOR MEMBERSHIP APPLICATION FORM

1. PARTICULARS OF MAIN MEMBER
Full Name in NRIC / Passport:
Membership No:
Membership Type:
Home Address:
Blk/ Street Name:
Unit No/ Building Name:
State/ City (if any):
Country:
Postal Code:
Tel:(H)(O)(M)
Email Address

2. PARTICULARS OF JUNIOR MEMBERSHIP APPLICANTS
i) Full Name:
Gender:
Preferred Name On Card:
Date of Birth:
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NRIC / Passport No :
(Last 4 characters/ digits of NRIC or Passport number)
H/P No:
Email Address :
Your Photograph :   (Format : Passport size in jpg of less than 2MB)


ii)   Full Name:
Gender:
Preferred Name On Card:
Date of Birth:
NRIC / Passport No :
(Last 4 characters/ digits of NRIC or Passport number)
H/P No:
Email Address :
Your Photograph :   (Format : Passport size in jpg of less than 2MB)


iii)   Full Name:
Gender:
Preferred Name On Card:
Date of Birth:
NRIC / Passport No :
(Last 4 characters/ digits of NRIC or Passport number)
H/P No:
Email Address :
Your Photograph :   (Format : Passport size in jpg of less than 2MB)


iv)   Full Name:
Gender:
Preferred Name On Card:
Date of Birth:
NRIC / Passport No :
(Last 4 characters/ digits of NRIC or Passport number)
H/P No:
Email Address :
Your Photograph :   (Format : Passport size in jpg of less than 2MB)


DECLARATION BY APPLICANT
  • I agree to my account being debited $5* (Category A1) / $10* (Category A2) every month for each Junior Membership(s) subscription fee and undertake to be responsible for all bills incurred by my child.
  • For reinstatement of membership: I agree that a reinstatement fee of $20* will be charged to my account.
  • I understand that a Junior member is not a member of the Society under the provisions of its Constitution i.e. he/she has no constitutional rights or privileges.
  • I understand that this privilege may be withdrawn at any time at the sole discretion of the Management Committee.
  • I agree to all terms and conditions listed below and I declare that the particulars provided are correct.
  • * Subject to prevailing GST.

  I HAVE READ AND AGREED TO THE FOLLOWING TERMS AND CONDITIONS

    

 

 




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Copyright © 2023 National University of
Singapore Society. All Rights Reserved
Web Design by Pixart Pte Ltd