1.

APPLICANTS PARTICULARS
[ ] Mr [ ] Mrs [ ] Ms [ ] Mdm
Full name as in NRIC/Passport
Surname: Given Name:
Preferred Name on Card:
NRIC/Passport No: Nationality:
Date of Birth: Gender: [ ] Male [ ] Female Marital Status: [ ] Single [ ] Married
[ ] Divorced [ ] Widowed
Home Address:
Postal Code:
Tel No: (H) (O) (H/P)
Email: Electronic SOA: [ ] Opt In
Matriculation Card No.:
J UNI OR MEMBERSHI P APPLI CATI ON FORM
(FOR NUS STUDENTS ONLY)
Please read the Membership Information overleaf carefully before completing the form.
Membership ID:
(for official use only)
Affix Principal
Cardholders
Photo Here
Please address application to: The National University of Singapore Society
Kent Ridge Guild House 9 Kent Ridge Drive Singapore 119241
or email mship@nuss.org.sg
NOTE:
i. Documents to accompany Application From
To expedite the application process, please complete the application form and submit it with the following
documents:
a. One recent coloured photo (Soft copy acceptable)
b. Copy of NRIC (front & back) or passport
c. Copy of matriculation card
d. Giro form
ii. Payment
Refundable Credit deposit of $100 via NETS/Cash/Visa/MasterCard/Cheque payable to NUSS.
iii. Upon receipt of all documents and payment, please allow 14 working days for processing.
BRI NGI NG A MARK OF DI STI NCTI ON I NTO YOUR LI FE
THE GRADUATE CLUB
Name of University Faculty Expected Date Year of
of Graduation Admission
1
2
Junior Membership Information (For NUS Students Only)
1. Eligibility
Type Of Membership Age (Years Old) Monthly Subscription Fee Validity Access to Facilities
NUS Undergraduate/ During Course $45* Upon graduation All except age-specified
students pursuing Duration of the degree outlets.
graduate coursework course taken
programme in NUS
a. Membership is non-transferable.
2. Rules and Regulations
a. J unior members are required to comply with the rules and regulations as laid down in the Societys Constitution & Regulations.
b. There will be no constitutional rights and privileges for J unior members.
c. J unior members are allowed to sign in 2 guests per visit.
d. J unior members are allowed to sign in 1 guest per vi si t at the fitness centre during off-peak period (Monday to Friday:
10am to 5pm & 8pm to 10pm) and subject to prevailing guest fee.
3. Monthly Subscription Fee
a. NUSS reserves the right to change the monthly subscription fee and impose certain terms and conditions as it deems fit from
time to time.
b. The monthly subscription fee billing commences once the application is approved.
c. The monthly subscription fee of $45* may be used to offset the entrance fee should the undergraduate member chooses to
convert the J unior membership to an Ordinary membership (only for undergraduates pursuing their first degree or postgraduate
degrees provided such postgraduate degrees commence within twelve(12) months after obtaining the first degree and
subsequent full-time degree).
d. In the event that the subscription fees paid exceed the entrance fee, the surplus will be converted to F&B credits and credited
into the members account. Offsetting subscription fees against entrance fee is only allowed within 3 months upon degree
conferment date.
e. The subscription fees are non-refundable if the undergraduate does not take up the offer to convert his/her J unior membership
to Ordinary membership within 3 months upon degree conferment date.
f. Members joining NUSS at a concessionary entrance fee shall not be permitted to transfer their membership within 3 years from
the date of joining.
DECLARATION BY APPLICANT
I, the applicant, understand the above listed and declare that the particulars in this application are correct.
I understand that the monthly subscription fee is non-refundable.
I am personally liable for the payment of the membership dues and charges incurred by me and my guests in the use of the
Societys facilities.
I agree to receive emails and other publicity materials from the Society and may choose to unsubscribe upon receipt of such
emails.
I agree to comply with and be bound by the Constitution, Rules and Regulations of the Society, as may from time to time be in force.
Signature of Applicant Date
* Prevailing GST applies and subject to change with prior notice. All information is correct at the time of print (February 2012).