honorary non-transferable term membership application form

HONORARY NON-TRANSFERABLE TERM MEMBERSHIP APPLICATION FORM
A
HONORARY NON-TRANSFERABLE TERM MEMBERSHIP TYPE
1-Year
B
PERSONAL PARTICULARS
Name as in NRIC/ Passport Dr Mr Mrs Ms Mdm Others ______
(IN BLOCK LETTERS)
Family Name Given Name Name to appear on Membership Card
Passport-size
Photograph of Applicant
NRIC/ Passport No. Date of Birth (DD/MM/YYYY) Nationality
Race Marital Status Gender
Single Married Others ______
Male Female
Annual Income
< S$60,000 S$60,000 – S$99,999 S$100,000 – S$199,999 S$200,000 – S$299,999 > S$300,000
Home Address
Postal Code
Home Telephone Mobile Telephone Home Facsimile
Company Name
Designation
Industry
Office Address
Postal Code
Office Telephone
Office Facsimile
Mailing Address
Home Office Others
(To State)
Billing Address
Home Office Others
(To State)
Primary Email Address
Secondary Email Address
Secretary/ Personal Assistant Name Email Address Telephone
In case of emergency, please contact (PLEASE INCLUDE NAME OF CONTACT & RELATIONSHIP)
Telephone
*Delete where appropriate
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C
SPOUSE PARTICULARS
Name as in NRIC/ Passport Dr Mr Mrs Ms Mdm Others ______
(IN BLOCK LETTERS)
Family Name Given Name Name to appear on Membership Card
Passport-size
Photograph of Spouse
NRIC/ Passport No. Date of Birth (DD/MM/YYYY) Nationality
Mobile Telephone Race Gender
Male Female
Company Name
Designation
Industry
Office Address
Postal Code
Office Telephone
Office Facsimile
Mailing Address
Home Office Others
(To State)
Billing Address
Home Office Others
(To State)
Primary Email Address
Secondary Email Address
D
JUNIOR DEPENDANTS PARTICULARS
Supplementary Cards can be issued to Junior Dependants of age not less than 12 years and not more than 24 years to visit the Club and use the facilities under your membership
and subject to terms & conditions stated in the Application Form for Supplementary Cards (Junior Dependants). Each issued card is chargeable at $30 (subject to prevailing GST)
per card. All applications are subject to management approval.
JUNIOR DEPENDANTS (Name as in NRIC/ Passport)
Family Name
Given Name
Relationship NRIC/ Passport No. Date of Birth (DD/MM/YYYY)
*Son/ Daughter
*Son/ Daughter
*Son/ Daughter
*Son/ Daughter
*Delete where appropriate
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E
APPLICANT’S DECLARATION
I, the undersigned Applicant hereby apply for the Honorary Non-Transferable Term Membership in ONE°15 Marina Club (the 'Club'), and the resultant privileges thereof.
I, undertake at all times to comply with and be bound by the Rules and Regulations and Bye-laws of the Club as may be prescribed and amended from time to time by the
Club and/ or SUTL Marina Development Pte Ltd (the ‘Proprietor’). In addition to the Rules and Regulations and Bye-laws of the Club, I acknowledge and agree specifically,
without limitation to the following:
o I am fully aware and agree that the Club is a proprietary club and that membership in the Club does not confer upon me any rights, title or interest in any property or assets
owned by the Club or available for use by the Club or its members.
o I will be personally liable for all applicable membership dues and charges incurred by me, my family and my guests in the use of the Club, its facilities or any reciprocal
clubs.
o I understand this application is subject to acceptance by the Club who reserves the sole right to decline any application without assigning any reason therefore.
o I warrant that all the information in this application is true and correct and that I am not a bankrupt and that no legal proceedings have been presented against me and I
have not been convicted of a criminal offence. In the event the warranty given in this paragraph is breached, I accept responsibility for any loss or damage that may be
suffered either by me or the Club.
o I confirm that in consideration of the Club agreeing to consider my application for membership, this application made by me shall be irrevocable.
o In consideration of the acceptance by the Club of my Honorary Non-Transferable Term Membership, I hereby agree and undertake that notwithstanding the Terms and
Conditions of the Rules and Regulations of the Club, my Honorary Non-Transferable Term Membership shall not be transferable.
o I understand each Honorary Non-Transferable Term Membership is issued for a period of 1 year and subject to the approval of the Club’s management.
o I understand I will be automatically deemed resigned from the Club on the expiry date of my membership tenure or the end of my term in office. Upon resignation of my
Honorary Non-Transferable Term Membership, all outstanding amounts must be settled and all issued membership cards and car labels (if any) must be returned to the
Club, otherwise chargeable.
o I understand Absent Status is not permitted under Honorary Non-Transferable Term Membership.
o I understand no berthing privileges are permitted for Honorary Non-Transferable Term Membership.
o In the event I default in any payments to the Club, be it in entrance fee, monthly subscriptions or any other monies owing to the Club, the Club shall have the rights to
suspend my membership privileges and thereafter to terminate my membership. If payment is not forthcoming, and all amount paid by us shall be forfeited to the
Proprietor absolutely as agreed liquidated damages and the Proprietor reserves the right to seek legal redress for all outstanding debts owing to the Club including legal
costs incurred, after membership termination.
o Prices and policies are subject to revision by the Management of the Club when necessary.
o By applying for the ONE°15 Marina Club membership, I authorize ONE°15 Marina Club to check on my credit, business ownership and litigation history.
Signature of Applicant Signature of Spouse Date
*Delete where appropriate
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G
FOR OFFICIAL USE ONLY
Date of application received
Sales Staff Name
Sales Staff Signature
Remarks
Designation
Signature/ Date
Background Screening
Director of Membership
Recommend for Membership
General Manager
Approval
Chairman
By (Staff Name) Department Signature/ Date
Application Processed
Membership Profile Created
Membership No.
Application Received by Finance
Membership Kit Issued
*Delete where appropriate
02/2013