Spouse Membership Application Form

1. PARTICULARS OF MAIN MEMBER
Full Name in NRIC / Passport:
(Surname)
(Given Name)
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 SPOUSE MEMBERSHIP APPLICANT
Salutation *
                                  
Full Name (as in NRIC / Passport)
Preferred Name On Card
NRIC / Passport No. *
(Last 4 characters/ digits of NRIC or Passport number)
Nationality *
Race*
Date of Birth (DD/MM/YYYY)*
Gender
     
Highest Education Attained *
Date of Marriage (DD/MM/YYYY)*
Email Address *
Contact No *
(Home)  (Mobile)

Photograph Upload
Your Photograph : *
 
(Format : Passport size in jpg of less than 2MB)
Company Information
Company Name
Address/No.
Unit #
 -
Street Name
Building Name
Country
Postal Code
Type of Business
Position/Job Title
Business Email
Business Phone
Business Fax
Promo Code
Promo Code (if applicable):
DECLARATION BY APPLICANT
  • I agree to my account being debited $10.70 every month for Spouse Membership subscription fee and undertake to be responsible for all bills incurred by my spouse.
  • For reinstatement of membership: I agree that a reinstatement fee of $21.40* will be charged to my account.
  • I understand that a Spouse 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  • I understand that this privilege may be withdrawn at any time at the sole discretion of the Management Committee.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.
  • *Inclusive of prevailing GST.

  I HAVE READ AND AGREED TO THE FOLLOWING TERMS AND CONDITIONS

    



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Copyright © 2020 The National University of
Singapore Society. All Rights Reserved
Web Design by Pixart Pte Ltd