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Become a member of SNSA today!

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SNSA Membership Application Form

1. Personal Particulars:

Note: Singapore number only

Note: If you are below 18 years old, written parental/legal consent
is needed. SNSA will contact you for proof of consent before accepting you as a member

Gender
Race
Spoken Language
Nationality

Note: Please note that only Singaporeans and Singapore PRs are allowed to sign up as members. If you are not a Singaporean or Singapore PR, you will not be able to join us as a member. However, please follow us on our social media platforms and join us for public events.

I am a
Please indicate your interest areas
How did you get to know about SNSA
Please indicate your preferred mode of contact

2. Legal Guardian:

Please provide a contact in case of an emergency.

Note: Singapore number only

2. Membership Type:

Membership Type

Note: With effect from 1st August 2019, Ordinary Membership Fees will be waived for 1 year from the date of joining.

I declare that all the information I have provided in this form is true and correct, and that I will inform SNSA of any change in the information.

I consent to Singapore National Stroke Association (SNSA) and their authorised agents and service providers processing my Personal Data for the following purposes: (a) Processing of membership application (b) Communication and publicity of SNSA’s programmes/initiatives/collaterals (c) Assessing of needs for service improvement (d) Purposes related to the services SNSA is providing and/or on matters relating to my ongoing membership with SNSA. I confirm that such consent (i) does not supersede any other marketing consents which I may have previously provided to SNSA and are in addition to any rights which the SNSA may have at law on personal data; and (ii) continues until such consents are withdrawn.

I would like to join SNSA mailing list and receive information about programmes, events and newsletters. By checking this box, I consent to SNSA processing my Personal Data for market research, marketing programmes and to contact me about their products, services and promotions via email, text messaging, telephone call, postal mail and/or social media. I understand that I am free to update my preferences including to unsubscribe from SNSA’s mailing list. I confirm that such consent (i) does not supersede any other marketing consents which I may have previously provided to SNSA and are in addition to any rights which SNSA may have at law on personal data; and (ii) continues until such consents are withdrawn.

I confirm that I am fit for the above event and shall release and not hold Singapore National Stroke Association (SNSA) or any of their employees, servants or agents liable in any way whatsoever for any loss, personal injury, mishap, accident, injury or loss of life and/or property arising directly or indirectly, as a result of or in connection with this event. I hereby agree that I shall keep SNSA, and their employees, servants or agents fully indemnified against any action, proceeding, liability, claim, costs and expenses incurred, suffered or sustained by me arising from my participation in this event. I also agree for my photographs to be used for SNSA publicity purposes.

Mode of payment

- Scan the QR code to make payment OR Bank Transfer to SNSA DBS Bank - Account number (028-009358-6)

Please double check your entries and try again.

Member Form Successfully Submitted!

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