MEMBERSHIP RENEWAL

Name of Cardholder: SURNAME GIVEN_NAME

NRIC/PP No: NRIC_NO

Name of Spouse:

NRIC/PP No:

1) Name of *Adult/Child:

Date of Birth: ____/____/__________

2) Name of Child:

Date of Birth: ____/____/__________

3) Name of Child:

Date of Birth: ____/____/__________

4) Name of Child:

Date of Birth: ____/____/__________

Local mailing address:

Email:

ADD1
ADD2
SINGAPORE PCODE

Phone (O/H):
__________________________
Phone: (HP): HP
Please circle the membership of your choice:

Science Explorer

1 year

2 years

2 Adults & 3 Children (3-16yrs old)

$ 50.00

$85.00

2 Adults & 4 Children (3-16yrs old)

$56.00

$95.00

3 Adults & 3 Children (3-16yrs old)

$60.00

$103.00

1 year

2 years

2 Adults & 3 Children (3-12yrs old)

$128.00

$198.00

2 Adults & 4 Children (3-12yrs old)

$144.00

$228.00

3 Adults & 3 Children (3-12yrs old)

$173.00

$283.00

1 year

2 years

$28.00

$34.00

(Unlimited visits to the Science Centre)

Cosmic Adventurer
(Unlimited visits to the Science Centre & regular 40min
IMAX movies)

Individual
(Unlimited visits to the Science Centre)

1 person

I would like to renew for the above Membership and enclosed is my cheque payment for the amount of
S$_____________.
Bank/Cheque No: _______________ / __________________
(Payable to: Science

Centre Board. Please do not send a postdated cheque or cash through mail)

____________________________
Signature of Cardholder

_______________________
Date

*Do bring along this letter if you wish to renew your Membership during the date of your visit.

--------------------------------------------------------------------------------------------------------------------------------------------For Official Use:

Link No: _____________________ Valid till: ___________________________ R/No: ________________