APPLICATION FORM

APPLICATION FOR NAME TO BE ENTERED

IN THE MEMBERSHIP REGISTER
9, Jalan Bukit Merah, Singapore 169543
Tel: 63272004 / 5 / 7 Fax: 63272009

The Executive Committee

Central Sikh Gurdwara Board
Singapore

Dear Sir

I wish to have my name entered as a Member in the Membership Register. My particulars are
as given below:

Name: ______________________________________________________________________

Alias (if any):__________________________________________________________________

Address:_____________________________________________________________________

____________________________________________________________________________

Tel: Home: _________________Office:______________________Fax:___________________

Email address: _________________________________________Mobile No.:______________

Date of Birth: ________________ Age: ____________________________________________

Nationality: ___________________________________________________________________

Identity Card Number: __________________________________________________________

Occupation/Profession: _________________________________________________________

I donate the sum of _________________________.

Signature: ___________________ Date: _____________________

For Official Use

Date received: ________________________________

Approved/Not Approved: ______________________ Date: ________________

* Minimum donation required for the membership is S$2,350.00

* Cheques are payable to CENTRAL SIKH GURDWARA BOARD