| 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) |
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| *Name (as it
appears in NRIC/Passport) |
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| *Sex |
|
| *Date of Birth (DD/MM/YYYY) |
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| *Marital Status (Single/Married/Divorced/Widowed) |
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| *Home
Tel No. |
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| *Office
Tel No. |
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| H/P No. |
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| *Home Address |
|
| |
|
| *Postal Code |
|
| Email
Address |
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| PLACE OF
WORK |
| *Ministry/Statutory Board/Others |
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| *Department |
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| *Office Address |
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|
|
| *Postal Code |
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| *Designation |
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| *Division (1/2/3/4) |
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| *Payroll Department |
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| 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 |
|
| OPTION TO PRINT PHOTOGRAPH ON
MEMBERSHIP CARD |
| Basic Card - Please indicate "Yes" or
"No" |
(If "Yes", please mail photo to
us) |
| Supplementary Cards - Please indicate
"Yes" or "No" |
(If "Yes", please mail photo to
us) |
| |
|
|
(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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