SINGAPORE CRICKET CLUB MEMBERSHIP APPLICATION FORM Membership Department, Connaught Drive, Singapore 179681 Telephone: +65 6338 9271 Fax: +65 6337 0119 Email: [email protected] Website: www.scc.org.sg APPLICATION FOR SPORTS MEMBERSHIP PLEASE READ – IMPORTANT NOTES ON SUBMISSION OF APPLICATION: Ensure that you complete all relevant sections of this application form, including Annex 1 (Personal Data Protection Act – Consent Form). Upon approval of your application, a membership package consisting of your membership card will be given to you and informing you to attend New Members’ Election Night. The following documents must be submitted together with your completed application form in order for the Club to consider your application:(1) All relevant documents pertaining to your sporting achievements and/or experience, including your Sports CV; (2) Cheque or Cashier Order payable to “Singapore Cricket Club” for the amount equivalent to the membership entrance fee including the prevailing goods and services tax and refundable deposit** of S$300 nett; (3) Photocopy (front and back) of NRIC or passport of applicant,spouse and children (if applicable); (4) Photocopy (front and back) of Employment Pass and/or documents evidencing applicant’s residency status in Singapore (if applicable); (5) Two passport-size colour photos of applicant, spouse and children (if applicable); (6) Marriage certificate (if applicable); (7) Express Consent Form; and (8) Completed GIRO Application Form (as attached to this application form). **This refundable deposit is compulsory and is for each member's credit facility. Members will be billed on a monthly basis via a statement of account. The deposit will be refunded to you when you cease to be a member of the Club. Payments submitted with this application and accepted by the Club shall not constitute an approval of the membership application. The payments shall be refunded to the applicant in the event that the application is rejected. Please note that if any of the foregoing docyments including the necessary payments are not furnished together with this application form, or if this application form is incomplete, your application herein will not be processed by the Club at all. Submission of this application can be done in person or by post addressed to the Membership Department. To check on the status of your application herein, please contact the Membership Department. Membership Application Form updated 01 August 2014 1 (A) PERSONAL PARTICULARS Surname: Title / Rank: *Mr / Mrs / Ms / Dr / Other: Given Name: Marital Status: Gender: NRIC / Passport Number: Date of birth (dd/mm/year): Nationality: Place of birth: Race: Religion: Residency Status: Male / Female *Singapore Citizen / Permanent Resident / Non Resident Singapore Immigration Pass Number (if applicable): Aggregate Number of Years in Singapore: Expected length of stay in Singapore: Residential Address: Postal Code: Residential Telephone: Mobile number: Email Address: Occupation / Designation: Company Name: Nature of Business: Company Address: Postal Code: Office Telephone: Office Fax: Degree / Professional Qualification (if any): Professional / Business Position(s) held over the past 5 years, with Name of Firm or Organisation (if any): Other Relevant Personal / Professional Background (if any): Please indicate where you prefer your mail to be sent to (tick one box only for each category) Correspondence Home Office Other: Club Magazine Home Office Other: Statement of Account Home Office Other: Other Club Memberships (in the past 5 years): Name to appear on Membership card: Reasons for joining the Singapore Cricket Club: How you get to know the Club ? __________________________(Through Club Member, Website, Magazine) If introduced through Club Member, please state the name and Membership number of that Club Member ____________________________________________________________________ Delete where appropriate 2 (B) PARTICULARS OF SPOUSE (TO BE COMPLETED IF MARRIED) Please refer to Rule 13(d). Surname: Title / Rank: *Mr / Mrs / Ms / Dr / Other: Given Name: NRIC / Passport Number: Date of birth (dd/mm/year): Nationality: Place of birth: Residency Status: *Singapore Citizen / Permanent Resident / Non Resident Singapore Immigration Pass Number (if applicable): Occupation / Designation: Company Name: Company Address Postal Code: Email Address: (C) Mobile number: PARTICULARS OF CHILDREN (TO BE COMPLETED IF RELEVANT) CHILD 1 Name(underline surname): NRIC / Passport Number: Date of birth (dd/mm/year): Nationality: Relationship: Place of Birth: Race: *Son / Daughter CHILD 2 Name(underline surname): NRIC / Passport Number: Date of birth (dd/mm/year): Nationality: Relationship: Place of Birth: Race: *Son / Daughter CHILD 3 Name(underline surname): NRIC / Passport Number: Date of birth (dd/mm/year): Nationality: Relationship: Place of Birth: Race: (D) *Son / Daughter FAMILY MEMBERSHIP APPLICATION (Please refer to Rule 13) Family membership must be accompanied by a marriage certificate, birth certificate(s) and two passport-size colour photos. (A child can only be registered as a Family Member if he/she is within the age group of 16 to 21 years old inclusive and single at the time of application.) Family membership is subject to the approval of the General Committee and the payment of the relevant prevailing monthly subscription. I wish to register my spouse as a Family Member. I do not wish to register my spouse as a Family Member. I wish to register my child/children as Family Member(s). I do not wish to register my child/children as a Family Member(s). * Delete where appropriate 3 (E) SPORTING BACKGROUND & ACHIEVEMENTS Relevant Personal Sporting Background and/or Achievements: Other Personal Sporting Background and/or Achievements (if any): (F) SPORTS SECTIONS Please fill in the section below if you/your family would like to join the respective sports sections. Do note that you are required to pay the relevant monthly section fee(s) for a minimum period of 12 months upon enrolling as a member of any sports section of the Club. I/We would like to join the following sports section(s) and agree to pay the relevant prevailing monthly section fee(s) for a minimum period of 12 months. The fees indicated are on a per month per person basis, excluding goods and services tax (GST). GST is payable on the fees. Sports Section Fees Balut $10.00 Billiards & Snooker $5.00 Bowls $7.00 Bridge $7.00 Cricket $10.00 Darts $6.00 Golf (Handicap: ____) $8.00 Hockey $10.00 Netball $10.00 Rugby $15.00 Soccer $15.00 Squash $5.00 Tennis $4.00 JSM Support Fund # # Member Spouse Children (Name) $8.00 The JSM Support Fund is used for tours, coaching and financial support for JSM conversion. 4 (G) TERMS & CONDITIONS Sports Membership I agree to the following terms and conditions:1. The General Committee of the Singapore Cricket Club (the “Committee”) has absolute discretion to:(a) approve or reject any application for membership without assigning any reasons whatsoever. In the event my application is rejected, then all payments submitted with this application shall be refunded to me (without any interest or compensation) by ordinary post; (b) at any time restrict the number of members of any or all categories of membership and/or close the membership of the Club from time to time; and (c) conduct subsequent launches for new memberships in such manner and on such terms as the Committee deems fit. 2. The membership fee is subject to prevailing government taxes. 3. Upon receiving written confirmation from the Committee that my application for Sports Membership has been accepted, I understand that I shall become a candidate awaiting election in respect of Sports Membership, subject to my payment of all monies due to the Club in accordance with the Rules of the Singapore Cricket Club (the “Rules”). I also undertake and agree to abide by and be bound by the Rules and any such regulations or byelaws as may be prescribed by the Committee and/or the Management from time to time and any other such amendments thereto, as well as all resolutions passed at the General Meetings of the Club. 4. Pursuant to Rules 14(c) and 23(a), a candidate awaiting election in respect of Sports Membership and a Sports Member is entitled to all the rights and privileges of a Sports Member (i.e. as set out at Rule 12(d)). In essence, such candidate awaiting election or Sports Member shall not be entitled to:a. b. c. d. vote or hold office; be co-opted to serve on the Committee or any Sub-Committee; nominate or second members for election into the offices of the Committee; and/or apply for Absent Membership. 5. I am aware that I need to pay monthly subscriptions from the date on which my application for Sports Membership is accepted, spend a minimum amount on food and beverage every month / quarter, and maintain a deposit with the Club pursuant to Rule 49. 6. Sports Membership is non-transferable and the Committee reserves the right to terminate my Sports Members at any time without assigning any reasons whatsoever. 7. The Sports Membership may be extended or renewed annually, upon my request in writing and in the Committee’s sole discretion, for an aggregate maximum period of five (5) years, subject to such terms and conditions and at such fees as may be determined by the Committee from time to time. I understand and accept that the Committee reserves the right not to extend or renew my Sports Membership without assigning any reasons whatsoever. 8. In the event that my Sports Membership is not extended or renewed, I will be entitled to convert my membership to Term Membership, subject to such terms and conditions and at such fees as may be determined by the Committee from time to time. 9. In the event that my aggregate term of membership with the Club reaches five (5) years, I will be entitled to convert my membership to Ordinary (Transferable) Membership, subject to such terms and conditions and at such fees as may be determined by the Committee from time to time. I am aware and accept that only a portion of the aggregate of five (5) years of fees paid as a member of the Club shall be taken into account for the purposes of computing / off-setting the conversion fee payable in this regard. 10. I am also aware and accept that, if I should fail to convert my membership to Term Membership (i.e. in the event that my Sports Membership is not extended or renewed) or Ordinary (Transferable) Membership (i.e. upon being invited to do so, after reaching a total of five (5) years membership) and within the time stipulated by the Committee, I will automatically cease to be a member of the Club upon expiry of the said time stipulated or expiry of the Sports Membership, whichever is the later, and I will also cease to be eligible for re-enrollment as a Sports Member, except with the prior written consent of the Committee. 11. Upon the expiry or termination of the Sports Membership, all rights and privileges accorded to me as a Sports Member shall cease, and I will also be deemed to have resigned as a member of the Club pursuant to Rule 24. 5 12. I am aware and agree that the Committee and/or the Management may, in order to consider my application for Sports Membership and my request(s) for extension or renewal (if any), conduct the necessary due diligence and/or background checks on me, which may include but shall not be limited to checking on my credit, business ownership and litigation history. 13. I also acknowledge that monies paid to the Club will only be refunded to me if my application for Sports Membership is rejected or withdrawn or deemed to have lapsed under the Rules, and that the Club is entitled to deduct all administrative fees and all debts (if any) due to the Club and incurred by me (including my family and my guests, where applicable) from the date of my application till the rejection or withdrawal or lapse of my application, as the case may be. The Club is also entitled to deduct all such outstanding amounts, if any, from the deposits made before refunding the balance to me in the event of my resignation as a Sports Member. 14. I further acknowledge that, pursuant to Rule 46, the Committee may grant waiver(s) in whole or in part in respect of entrance fees and/or subscriptions, and that the Committee may do so generally or in respect only of individual members or of particular categories of members. In the event that any such waiver(s) are granted to me, I understand that such waiver(s) are revocable at any time by the Committee in writing and in their sole discretion, but that the revocation will not have restropective effect. 15. I acknowledge and agree that should I default on any payments to the Club, be it in entrance fee, monthly subscriptions or any other monies owing to the Club, the Club shall be entitled to suspend my membership privileges and thereafter terminate my membership. If no payment is forthcoming, the Club reserves the right to seek legal redress for all outstanding debts owing to the Club including legal costs incurred in connection thereto, whether before or after my membership is terminated. 16. I am aware and agree that if I am found to be ineligible to be a member of the Club pursuant to this application, I am not entitled to apply to be a member for a period of one (1) year except with the prior written consent of the Committee. 17. In accordance with the Rules, I am also aware that a member shall cease to be a member of the Club and their names shall be removed from the Club’s list of members in any of the following events where the member:(a) (b) (c) (d) (e) has resigned or died; has been adjudicated bankrupt, as from the date of such adjudication; makes a composition or arrangement with his creditors under the provisions of any Ordinance or Act; has been expelled from the Club; has been convicted in a Court of Law of competent jurisdiction of any offence which in the opinion of the Committee would, if permitted to remain as a member, place the Club in disrepute or embarrass the Club in any way; (f) flees the country to escape criminal proceedings; or (g) has become an enemy alien. (H) DECLARATIONS General Information 1. Have you been adjudged a bankrupt in any country? If yes, please provide further details. ______________________________________________________________ Yes / No 2. Are you an undischarged bankrupt in any country? Yes / No 3. Have you been convicted in a court of law in any country for any offence? If yes, please state relevant details:_______________________________ Yes / No 4. Have you made a composition or arrangement with your creditor(s) under the provisions of any Ordinance or Act in any country? Yes / No 5. Have you been expelled from the Club or any club in any country? Yes / No 6. Have you fled from any country to escape criminal or civil proceedings? Yes / No 6 Applicant’s Declaration I, the undersigned, hereby apply for the Sports Membership of the Singapore Cricket Club (the “Club”). I declare and warrant that all information provided in this application is true and correct and that I am not a bankrupt and that no bankruptcy or legal proceedings have been commenced or threatened against me. I undertake to notify the Club if any information I have provided becomes untrue, inaccurate or misleading, or if any bankruptcy or legal proceedings is commenced or threatened against me at any time subsequent to this application herein (i.e. whilst pending the outcome of my application herein, and if my application is accepted by the Club, whilst I am a candidate awaiting election and/or thereafter a member of the Club). I also agree to provide any further information that is available to me and that the Club may request in relation to my application or membership. In the event that the warranty / declaration given herein is breached, I accept responsibility for any loss or damage that may be suffered by me or the Club, and also hereby agree to indemnify the Club for any such loss or damage suffered by the Club. Also, in the event that any of the information provided in this application is found to be untrue and/or incorrect, or should any bankruptcy or legal proceedings be commenced or threatened against me following the submission of my application herein, I acknowledge and accept that the Club may reject my application for membership herein and/or terminate my membership (as the case may be) without assigning any reasons whatsoever. I also agree that I shall be bound by the Club’s Rules and Bye-Laws and other regulations currently in force, and those that may be added or amended by the Club from time to time as it may consider appropriate. Applicant’s Signature Date: Spouse’s Signature (if applicable) Date: (I) PAYMENT This application must be accompanied by payment of the full membership entrance fee of _______________ (less rebates, if any, as shall be prescribed and/or determined by the Committee from time to time), together with the prevailing goods and services tax, and refundable deposit of S$300 nett. Payment can be in the form of cheque or cashier’s order made out in favour of the ‘Singapore Cricket Club’, crossed and indicated with ‘A/C Payee Only’. Please indicate your name and address clearly on the reverse side of the cheque / cashier’s order. 7 (J) FOR OFFICIAL USE ONLY Date Received: Mode Received: Received By: Receiving Staff’s Signature: Mode of Payment: Cheque / Cashier’s Order No.: Remarks (if any): Designation Proposal for Sports Membership: Remarks (if any) Signature / Date (1) Sports Section Convenor (2) Games Control Board (1) Chairman of Rules & Membership SubCommittee Background Checks: (2) General Manager Recommend for Membership: Chairman of Rules & Membership SubCommittee Membership Approval: General Committee Date Processed: Processed By: Application Status: APPROVED / REJECTED Commencement Date: Membership No. Assigned: 8 PERSONAL DATA PROTECTION ACT (PDPA) MEMBER’S CONSENT FORM Step 1 : Step 2 : Print this form, complete and sign it Mail, fax or email the completed form to: Member’s Name Member’s Identification / Passport Number Membership Number : : : Membership Department Singapore Cricket Club Connaught Drive, Singapore 179681 Telephone: +65 6338 9271 Fax: +65 6337 0119 Email: [email protected] _________________________________ _________________________________ _________________________________ SECTION 1: UPDATED PERSONAL CONTACT PARTICULARS (COMPULSORY) Home Number: Mobile Number: Fax Number: Office Number: Company Name: Designation: Home Address: Mailing Address: Email Address: SECTION 2: CONSENT I would like to be kept informed of the latest announcements, news, events, surveys, marketing and advertising information and promotions by the Singapore Cricket Club (the “Club”). Pursuant to the above, I hereby authorise, agree and consent to allow the Club to:a) b) c) collect, use, disclose and/or process personal data about me that I had previously provided to the Club, now provide to the Club, may in future provide to the Club and/or which the Club possesses about me, including but not limited to my name, my identification number, my telephone numbers, my mailing address, for the following purposes, namely:- (i) to perform or carry out all matters that are necessary and/or relevant to the purposes of maintaining or administering or furthering my ongoing membership with the Club; and (ii) to provide me with marketing, advertising and promotional materials, information and/or documents relating to products and/or services and/or events that the Club may be marketing, selling, offering or promoting (as the case may be), whether such products and/or services and/or events exist now or are created in the future (the “Purposes”); contact me for the purposes of providing me with information, materials and/or documents on any events, products, services or promotions provided or marketed by the Club, via the following mode(s) of communication (i.e. pursuant to the personal contact particulars that I have provided in Section 1 and/or Section 2(a) above), even if I am or become registered in the Do-Not-Call Registry: Post / Mail / Courier Email Phone call SMS / MMS Fax None of the above (Please select at least one) disclose personal data about me to the Club’s third party service providers and/or agents (eg. the Formula 1 and other local/ regional/international event or tournament partners) for the above Purposes; in this connection, I also consent to such third party service providers and/or agents of the Club processing my personal data (including sending me marketing, advertising and promotional information and/or documents through the above selected modes of communication) for the above Purposes of the Club. 9 Please note: (1) You may, at any time, withdraw your consent for the Club and/or its third party service providers and/or agents to collect, use, disclose or process personal data about you for the above Purposes, or for inclusion in the mailing list for marketing materials by the Club. However, you acknowledge that by withdrawing your consent, the Club may not be able to continue maintaining or administering or furthering your membership effectively and/or you may miss or fail to receive relevant notices and messages pertinent to your ongoing relationship with the Club. (2) If you have any questions about the Club’s use of your personal information, or you wish to let us know about changes to your personal details held by the Club, or if at any time you wish to stop receiving marketing information and/or documents from the Club and/or its third party service providers and/or agents, then please contact the Club’s Data Protection Officer at [email protected]. SECTION 3: AUTHORISATION AND AGREEMENT I also confirm that, where personal information of other person(s) have been disclosed by me or may be disclosed by me in the future for the purposes of my membership with the Club, I have obtained or will obtain (as the case may be) the prior consent of such person(s) to the disclosure of his/her/their respective personal data for the purposes of my disclosure to and collection by the Club. SECTION 4: AUTHORISATION AND AGREEMENT I confirm and agree that I have read and understood the above provisions, that my consent granted herein shall supercede any other consent or withdrawal of consent which I may have previously provided to the Club in relation to contacting me for the purposes of providing me with information and/or documents on the latest announcements, news, events, surveys, marketing and advertising information and promotions by the Club, and that the personal contact particulars provided by me in Section 1 above are true, accurate and up-to-date, and that I am the user/subscriber of the telephone and/or fax number(s) and/or email address(es) provided by me above. Member’s Signature Date FOR OFFICIAL USE ONLY Date Received: Mode Received: Processed By: Staff’s Signature Date Processed: 10 11 12
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