Application Form for Spouse Membership - Chinese Swimming Club

APPLICATION FOR CREDIT ACCOUNT
I. PRINCIPAL/TERM/JUNIOR TERM MEMBER’S PARTICULARS
*delete where inapplicable
Name (English):
(*Dr/Mr/Mrs/Ms/Mdm)
NRIC/Passport No.:
Date of Birth:
Chinese:
Residential Address:
Postal Code:
Type of Membership: *Ordinary/Associate/Corporate/Term/Junior Term
A/c No.:
Tel No.: (H) (O) (HP)
II.
AUTHORISATION OF SPOUSE TO SIGN BILLS INCURRED AT THE CLUB:
SPOUSE’S PARTICULARS
Name (English):
(*Dr/Mr/Mrs/Ms/Mdm)
Tel No.:
NRIC/Passport No.:
Occupation:
Date of Birth:
Chinese:
Note: Junior Member is only applicable to any child born before 30 April 2000 and whose parent is a Principal
Member before 30 April 2000 & have registered with the Club for eligibility for Junior Membership before
29 April 2001.
III. Authorisation of *child/children (12 to 21 years) who is/are registered as *Junior member(s)/
Child member(s)/Child Term member(s) of the Club to sign bills incurred at the Club.
JUNIOR/CHILD/CHILD TERM MEMBER’S PARTICULARS
No. Name of Child Birth Certificate/NRIC No.
1.
2.
3.
4.
I hereby submit my application with the specimen signature form authorising my *spouse/child/children to sign any
bill incurred at the Club to be debited to my credit account.
I hereby undertake to abide by the Constitution and Bye-Laws of the Club now in force subject to any amendments
from time to time.
Signature of Principal/Term Member
Date
FOR OFFICIAL USE
Receipt/Cheque No. : Adjustment Memo No. :
Amount : Date of Payment :
Date Joined : Approved by :
(For transferred members only)
Attended by :
Senior Manager, Membership Relations