CONFIDENTIAL
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one photograph
for PAssion Card
PEOPLE’S ASSOCIATION
VOLUNTEER REGISTRATION
This form may take you 5 minutes to fill in.
PART I
NAME OF COMMITTEE
Name as in NRIC (In BLOCK and underline surname) Name in Chinese Character
*Dr/Mr/Mdm/Mrs/Miss (if applicable)
NRIC No. Date of Birth (dd/mm/yy) Title of National Day Award &
Year Awarded (if any)
Singapore PR *Yes/No/NA Sex Male Female
Race Marital Status Single Married NS Status (if applicable)
Full Time
Widowed Divorced/Separated Reservist
Nationality Country of Birth Exempted
Religion Language/Dialect
Written ________________________ Spoken _________________________
Highest Educational Level Attained Primary Secondary *GCE ‘N’/‘O’ ITE GCE ‘A’
Diploma Pass Degree Honours Degree Master’s Degree Doctorate
Name of Diploma/Degree Attained ______________________________________________________________
Name of Polytechnic/University Attended_________________________________________________________
Home Address ________________________________________________________________________________
Postal Code ________________ E-mail Address ____________________________________________________
Home Telephone No. ________________________ *Pager/Handphone No. _____________________________
Type of Dwelling HDB_____ - Room HDB Executive HUDC Bungalow
Semi Detached/Terrace Condominium/Private Apartment Others, specify __________________
PART II
Occupation Name of *Employer/Company (please specify if you are self-employed)
Workplace Address ____________________________________________________________________________
Postal Code _____________ Workplace Telephone No. ________________ Fax No. _______________________
______________________________________ _____________________
Signature of Applicant Date
FOR OFFICIAL USE
Endorsed by
Position Recommended ___________________________________
Recommended by _______________________ _______________ __________________________________
Name & Designation Signature & Date Signature of Adviser & Date
*Delete as necessary √ Tick wherever appropriate PA/FS/01/2005