(ffii. transferable memb ership APPLICATION FORAI. pafso. SlAIGAP OflT"S PBEMIER O,4S1S OAT THE PADANG

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1 (ffii pafso transferable memb ership APPLICATION FORAI SlAIGAP OflT"S PBEMIER O,4S1S OAT THE PADANG

2 OaDI1\AfiY,'ffMNSFE TE),MEMB,ERSIilP f-] New eppltcanon f 1 rnnnsren Note: A candidate is required on application to deposit the prevailing Entrance Fee (except for transfer cases), three months' Subscription Fee, Bar and Restaurant deposit and two colour passport photographs (non-returnable). GSf ls applicable for all payments. FULL NAME AS IN NRIC: PLEASE UNDERLINE SUBNAME DATE OF BIRTH: PLACE OF BIRTH RACE: (MR/DR/PROF) NRIC/PASSPORT NO.: MARITAL STATUS: NATIONALITY: WEDDING ANNIVERSARY DATE (IF APPLICABLE): HOME ADDRESS: HOME TELEPHONE NO PROFESSION: DESIGNATION: NAME OF : ADDRESS: OFFICE TELEPHONE NO. HANDPHONE NO.: DID: OFFICE FAX NO,: PAGER NO HOME FAX NO.: ADD: NAME OF INSTITUTE/SCHOOL IF YOU ARE STILLA STUDENT NAME TO BE PRINTED ON MEMBERSHIP CARD: (MAXIMUM 1 8 CHARACTERS) The Club will not accept applicants for membership who are on employment pass. Please check with the office before any such application is made. PLEASE SEND ALL CORRESPONDENCE TO: (1) STATEMENT tr HOME (2) LETTER tr H)ME (s) MAGAZTNE HOME tr POST BOX ADDRESS NOT ACCEPTED tr tr tr NAME OF CLUB MEMBERSHIP NO..r.

3 PARTICULARS OF SPOUSE Please note that the family membership is only applicable to Patron, Life, Veteran or Ordinary Members. (1) Do you wish your spouse to receive a membership card? FULL NAME AS IN NRIC: DATE OF BIRTH: NRIC/PASSPORT NO.: PROFESSION: PLEASE U NDERLINE SU BNAM E PLACE OF BIRTH: NATIONALITY: DESIGNATION: BACE: NAME OF : ADDRESS: HANDPHONE NO,: ADD: OFFICE TELEPHONE NO NAME TO BE PRINTED ON MEMBERSHIP CARD: SIGNATURE OF SPOUSE: (MAXI M U M 1 I CHARACTE RS) PARTICULARS OF CHILDREN (2) Do you wish your child/children who is(are) above the age of 12 years and below 21 years to receive (a) membership card(s)? lf Yes, your account will be charged for the prevailing Family Subscription Fee accordingly. *The member must inform the Ctub when his children have attained the age 21. This is to expedite the cessation of his/her membership. NAA/IE OF CHILD DATE OF BTRTH (DD/MM.YY) NRIC/BC NO. SEX.r. CR ED IT S IGN ING FACILITI ES For your children who are above 14 years and below 21 years of age NAME NRIC NO. SPECIMEN SIGNATURE l, as the principal account holder, hereby agree and acknowledge to undertake all expenses incurred by my spouse and children to be debited to my monthly account in accordance with the Club's Bules and Bye-Laws. APPLICANT'S SIGNATURE DATE

4 RULE 6 ORDI]TffiY(TBANSFE >IL {/igp,:*fh,asfita*tlffi RAI{STERABLE) MEMBERS}I..IP i) ii) i ii) iv) v) vi) vii) viii) ix) x) An Ordinary (Transferable) Member may, with the prior approval of the Committee, transfer his Membership to any other person of the male gender subject to the payment of a Transfer Fee to be determined by the Committee in its sole discretion. A Lady (Transferable) Member may, with the prior approval of the Commiftee, transfer her Membership to any other person of the female gender subject to the payment of a Transfer Fee to be determined by the Committee in its sole discretion. Upon the death of the Ordinary (Transferable) Member/Lady (Transferable) Member, the Committee may in its absolute discretion, on payment of a Transfer Fee as decided by the Committee, transfer the membership of the deceased member to the person nominated by the deceased member prior to his/her death. lf the said Nominee, who is approved by the Committee, is under the age of twenty-one (21), the membership shall be held in abeyance until he attains the age of twenty-one (21). lf the said Nominee is not approved by the Committee, the Nominee shall be required to dispose of the Membership, upon payment of a Transfer Fee, within a period ot six (6) months from the date of rejection by the Committee. ln the event of there being no Nominee, the deceased's estate shall be required to dispose of the Membership, upon payment of a Transfer Fee, within a period of six (6) months from the date of the grant of Letters of Administration or the Grant of Probate, whichever is the case. The Committee reserues the absolute right to reject the eligibility of the Nominee for the Membership. ln the event that an Ordinary (Transferable)/Lady (Transferable) Member defaults and his Membership is revoked as a result of non-compliance with any of the Rules of the Club, the member is given up to six (6) months to dispose of his membership, upon payment of a Transfer Fee.

5 Q,t1,ES?,r,O]YNffBE Ql. Q Qs. Q4. Q5. Q6. Are there currently any bankruptcy notice(s) served against you? Are you currently an undischarged bankrupt? Are you currently facing any criminal charges in any court of law? Have you been convicted of any criminal charges in any court of law? Have you been refused admission to any club? Are you taking up financing of SRC membership with any bank? Q7. lf yes to Q6, name of bank and branch: Q8. lf yes to Q6, please state the time frame for repayment of loan: years. DECIARATION Declaration by Candidate: I, the candidate named above, have read and understood the amended Rules and Bye-Laws of the Club. I will ensure that the Club's Rules and Bye-Laws are observed at all times if I am elected a member. I also fully understand that the Management Committee reserves the right to approve or reject my application without assigning any reasons whatsoever. APPLICANT'S SIGNATURE DATE FOR OFFICE USE ONLY DATE RECEIVED: BANI</CHEQUE NO.: AMOUNT PAYABLE: COMMENCEMENT DATE: APPLICATION HANDLED BY: RECEIVED BY: RECEIPT NO,: DAT E AP P ROV ED/R EJ ECTE D : ALLOCATED MEMBERSHIP NO, : (NAME OF STAFF) SIGNATURE OF MEMBERSHIP COMMITTEE CHAIRMAN:

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