Please read Annex A carefully before completing the form.
1. APPLICANT'S PARTICULARS
Preferred Name on Card
NOTE: Download the NUSS MOBILE APP to access your membership e-card and other benefits!
NRIC / Passport No: (Last 4 characters/ digits of NRIC or Passport number)
Nationality:
Your Photograph :
(Format : JPG of less than 2MB)
Education Information:
Bachelor's or First Degree:
Name of University
Degree
Year of Graduation
Degree Certificate :
(Format : JPG of less than 2MB)
(If more than one degree/subsequent postgraduate degree(s)):
Name of University
Degree
Year of Graduation
Name of University
Degree
Year of Graduation
Tel:(H)(O)(M)
Email:
Preferred Mailing Address:
Vehicle Registration No. :
(For Mandalay Guild House carpark only)
Is the vehicle registered under your name?
Company Name (if any):
Tel:Fax
Designation:
Nature Of Business:
(Click here if applying for Spouse Membership)