| PERSONAL DETAILS OF
APPLICANT |
| *NRIC/Fin No. (eg
S1234567A) |
|
|
(To be completed
correctly. If not, you will not be able to access our e-booking
system) |
| Staff No. (If applicable) |
|
| *Title (Dr/Mr/Mrs/Mdm/Miss) |
|
| *Name (as it
appears in NRIC/Passport) |
|
| *Sex |
|
| *Date of Birth (DD/MM/YYYY) |
|
| *Marital Status (Single/Married/Divorced/Widowed) |
|
| *Home
Tel No. |
|
| *Office
Tel No. |
|
| H/P No. |
|
| *Home Address |
|
| |
|
| *Postal Code |
|
| Email
Address |
|
| PLACE OF
WORK |
| *Ministry/Statutory Board/Others |
|
| *Department |
|
| *Office Address |
|
|
|
| *Postal Code |
|
| *Designation |
|
| *Division (1/2/3/4) |
|
| *Payroll Department |
|
| Uniform/Civilian |
(To be completed for those on contract
in uniform groups) |
| Contract Expiry Date (DD/MM/YYYY) |
(To be completed for those on contract
in uniform groups) |
| ACTIVITIES/SPORTS
INTERESTED (eg. Aerobics, Bowling, Fishing, Tennis, Dancing,
etc)
|
|
Please indicate |
|
|
|
|
|
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| SUPPLEMENTARY
CARD APPLICATION FOR SPOUSE AND
CHILDREN |
(For spouse and up to
three unmarried children between ages of 12 and 21. An administrative fee of $10
for each supplementary card is payable. Cheque made to "Civil
Service Club" should be sent to "Membership Section,
Civil Service Club, 60 Tessensohn Road, Singapore 217664) |
|
|
| Name |
(Spouse) |
| NRIC/Fin
No. |
(eg S1234567A, F1234567A) |
| Date of Birth (DD/MM/YYYY) |
|
| Name |
(1st Child) |
| NRIC/Fin/BC No. |
(eg S1234567A, F1234567A) |
| Date of Birth (DD/MM/YYYY) |
|
| Sex |
|
| Name |
(2nd Child) |
| NRIC/Fin/BC No. |
(eg S1234567A, F1234567A) |
| Date of Birth (DD/MM/YYYY) |
|
| Sex |
|
| Name |
(3rd Child) |
| NRIC/Fin/BC No. |
(eg S1234567A, F1234567A) |
| Date of Birth (DD/MM/YYYY) |
|
| Sex |
|
| |
|
Ordinary
Membership
One (1)
colour passport-size photograph is needed. The photograph can either
be submitted via post or attach as an JPEG file via email. Please
remember to indicate your name and nric
on the back of the photograph if you are
sending it by post. |
| PHOTOGRAPH ON
MEMBERSHIP CARD |
| Please mail
photo to us or soft copy in jpeg format via e-mail to csc_qsm@csc.gov.sg |
| Supplementary
membership application form |
|
PHOTOGRAPH ON MEMBERSHIP CARD
One (1) colour passport-size
photograph is needed. The photograph can either be submitted via post
or attach as an JPEG file via email to csc_qsm@csc.gov.sg. Please
remember to indicate your name and nric on the back of the photograph if you
are sending it by post. |
|
I declare that all the particulars given by
me above are true and correct. Attached is a cheque payment (being card
administrative fee) for $_____ ($10 per supplementary card) made payable to
"Civil Service Club". |
| |
|
|
(a) I declare that all the particulars given by me above are true
and correct. I undertake to observe all the Rules and Regulations of the Club
and not to act in any manner detrimental to its interest.
(b) I understand that I
have to give the Club two months' notice in writing in order to
resign as a member.
(c) I undertake to
forward to the Club a cheque for
the
supplementary cards applied (administrative fee of $10 is chargeable for each
supplementary card) .
(d) I note that the
subscription fees are payable directly to Civil Service Club if I were to
be granted no-pay-leave/maternity leave, etc, for the period of the
no-pay-leave/maternity leave. |
|
| This
form is electronically transmitted and does not require a signature.
By clicking the "Submit" button, you hereby agree and authorise the
Civil Service Club to instruct your Payroll Department to deduct a
monthly subscription of ($6 or $3 per month depending on your
divisional status) from your salary. Please note that upon
submitting the form, your membership takes effect from the
CURRENT month. Subscription is based on a MONTHLY basis and
will not be
pro-rated. | |
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