Dazhong Primary School Alumni

Membership Application Form

Congratulations on taking your first step towards becoming an alumni member of Dazhong Primary School.

  • This form may take 10 minutes to complete.
  • Please prepare a scanned copy of your PSLE Certificate or Dazhong Primary School Report Book and email it to

Personal Particulars (Indicate NA for Non-Applicable)

Full Name:______DOB: ______(DDMMYYYY)

NRIC No:______Gender: M / F

Nationality:Singaporean / Singapore PR / Malaysian / Other (Pls indicate) ______

Race:Chinese/ Malay / Indian / Other (Pls indicate) ______

Marital Status: Single / Married / Divorced

Address: ______

______Postal Code ______

Contact No:______(Home) ______(Mobile)

E-mail:______

Food:Vegetarian / Non-vegetarian Food Allergy (if any): ______

Medical condition/history (if any): ______Drug Allergy (if any): ______

Education History

Years attended in DZPS (YYYY-YYYY):______P6 Class: ______

CCA(s) in DZPS: ______Leadership Position (if any): ______

Highest Education Qualification:______

Institution / University of Highest Education Qualification: ______

Are you currently volunteering with any organisation? Yes / No

If yes, pls indicate: ______

(Please turn over)

If you would like to get in touch with any former teachers, kindly list them down.

______

Areas of Interest/Expertise:______

(E.g. Art Club, Badminton, Choir, Dance Club, Environment Education, Junior Orchestra, Sports Club, Soccer, Wushu)

What is your interest level in volunteering with the DZPS?

I am interested in being part of the Committee, to attend monthly meetings and plan activities together with other alumni members.

  • Day & Time preferred: ______

I am not able to commit to the Committee, but I would like to be updated on school and alumni activities, and to be able to volunteer on an ad-hoc basis.

Declaration & Verification

Have you ever been convicted in a Court of Law? * Yes / No

(If yes, pls provide details: ______)

I understand and agree that Dazhong Primary Alumni Association may collect, use and disclose my personal data, as provided in this application form, or obtained by the Association as a result of my membership, for the following purposes in accordance with the Personal Data Protection Act 2012: (a) the processing of this membership application; and (b) the administration of the Association

Yes, I understand and agree

I declare that all information provided in this application and in documents submitted is true and correct to the best of my knowledge. I understand and agree that any false information, misrepresentation, or omission of facts may be justification for refusal of application or termination of membership.

Yes, I understand and agree

Signature: ______Date of submission: ______