Member Service Order Form Apply and Renew

A. General Information

Full Name as in NRIC/ Passport:*

 

Residential Address in Singapore:*

 

NRIC/ Passport No:*

 

Gender:*

Age:*

Date of Birth:*

Martial Status:

Occupation:

Company:

 

B. Contact Information

Telephone: (Home)*

(Office)

(Fax)

(Pager/ Mobile)*

Email Address:*

IN CASE OF EMERGENCY, PLEASE CONTACT

Name:*

Relationship:

Telephone: (Home)*

(Office)

(Pager/ Mobile)*

 

C. Personal Information (Optional)

Please write a few lines to introduce more about yourself:

Nickname preferred:

UIN (ICQ User):

Nickname (ICQ User):

 

D. Membership Information

Membership Option:*

Membership Type:*

Name as appear on Membercard:*

Membership No:*

 

E. Agreement

Terms and Conditions:
  1. Talentsland Productions® reserves the right to terminate the membership
    of the respective member at any time.
  2. TalentsLand Productions® reserves the right to amend/ cancel any event organizes.
  3. All information provided above is strictly for TalentsLand Productions®.
  4. The information provided above are correct at time of submit.
  5. Any changes in information will be updated to TalentsLand Productions®.

 

* I ACCEPT and AGREE all the terms and conditions stated in this application form and hereby hold myself solely responsible.

 

 

 

 

Notes for Applicant:
  1. It is compulsory to complete Section A, B, D and E.
  2. Please ensure fields with red asterisk(*) in Section A, B, D and E are completed.
    If not applicable, please state NA.
  3. It is optional to complete Section C.