SBPF MEMBER APPLICATION FORM

Membership type: Ordinary / Corporate / Institution Appointed/Elected Position : ____________________________(if any) (Office Bearer or sub-committee or member) APPLICANT INFORMATION Name (as in NRIC or passport): _________________________________________ (Please underline surname) Name of Organisation: ________________________________________________ I am a (tick one): Singapore Citizen Singapore Permanent Resident

Foreigner requiring a pass to work in Singapore Address: ___________________________________________________________ _______________________________________ Postal Code: ________________ Contact No.: ______________ Email address: _____________________________ Date of Birth: _________________ Age: ___________ ACADEMIC QUALIFICATIONS Date From To Schools/Institutions Attended Qualifications Obtained (O/A Levels, Diploma, Degree) Subjects/Grades

OTHER QUALIFICATIONS / COURSES ATTENDED / AWARDS ATTAINED Date From To Qualifications / Awards Obtained Awarding Institution

Are you a discharged bankrupt : Yes / No Discharged date : ___________________ Any criminal records : Yes / No 1

EMPLOYMENT HISTORY Date From To Firm/Institution (in chronological order) Position Held Key Responsibilities

REFEREES 1. Name: ____________________ Designation: _______________________ Organisation Name: ____________________________________________ Contact No.: _________________ Email Address: ____________________ 2. Name: ____________________ Designation: _______________________ Organisation Name: ____________________________________________ Contact No.: _________________ Email Address: ____________________ REASON(S) FOR APPLYING FOR THIS MEMBERSHIP

I verify that the above information is correct to the best of my knowledge. I accept that providing false information deliberately could result in my dismissal. I am also aware that any position given and accepted by me is based on voluntary basis and I will not be paid. I also know that i am also needed to update any changes to the information provided in this form. As I a member, I am also aware that I am subjected to the clauses provided in the Memorandum & Article, terms and regulation of Singapore Bodybuilding and Physique Sports Federation (SBPF).

Signature/Chop: ______________________

Date: __________________________ 2