MEMBERSHIP APPLICATION FORM (For Ordinary Membership)

A: BASIC INFORMATION
1. Name (Last): / 2. Name (First & Other): / 3. Male[ ]
Female[ ]
4. Primary Email Address:
Alternative Email Address:
/ 5. Date of Birth:
dd/mm/yyyy
6. Citizenship:
/ 7. If not a Singapore Citizen, are you a Singaporean PR Yes [ ] No[ ] / 8. NRIC No or FIN:
B: EDUCATION (Oxbridge)
1. College:
/ 2. Oxford[ ] Cambridge [ ] / 3. Degree:
4. From (Year):
/ 5. To (Year):
/ 6. Subject:
C: EMPLOYMENT
1. Occupation:
/ 2. Employer:
D: OTHER CONTACT DETAILS(Note: Please provide your residential address in Singapore.)
1. Postal Address: Home [ ] Work[ ] Other[ ]
2. Other Address (if any): Home [ ] Work [ ] Other[ ]
3. Tel (Office):
/ 4. Tel (Mobile):
/ 5. Tel (Home):
/ 6. Tel (Other):
E: OTHER INFORMATION
Please indicate any other Oxbridge affiliation (e.g. attended more than one Oxbridge college, member of other
Oxbridge Society, spouse or family member is Oxbridge alumnus,etc):
F: STATEMENT, DATE & SIGNATURE
To: The Honorary Secretary, The Oxford and Cambridge Society of Singapore
I confirm that I am residing in Singapore, that I am or have been a member of Oxford and/or Cambridge University (or Universities) and that the information provided in this Application Form is true and correct to the best of my knowledge.
I wish to pay S$60 and apply to be an Ordinary Memberfor calendar year 2017. I understand Ordinary Membership renewal shall be made no later than 31 March in 2018. Please note that Ordinary Membership rates will go up to S$100 from calendar year 2018 onwards.
(Please refer to overleaf for important payment information).
Payment Mode: By Cheque [ ] By Bank Transfer [ ]
By applying for this membership, I give consent to the Society to collect, use and disclose my personal data for membership purposes. I also consent to receiving Society-related news and events from the Society. I understand that my information may be disclosed to third parties for verification purposes.
The Society is committed to safeguarding personal data under the provisions of the Personal Data Protection Act (2012). Please refer to the Society website for our Data Protection Policy.
Date of Application: Signature:
ADDITIONAL INFORMATION: MAKING PAYMENTS
Please email this form to: &
By Cheque
Cheque should be made out to: “The Oxford and Cambridge Society of Singapore”
Send in your cheque to the following address:
Attn: Maribel
Re: Oxbridge – (membership)
77 High Street
#03-01 High Street Plaza
Singapore 179433
You should drop an email to with the appropriate subject to alert the Secretariat to look out for the cheque.
By Bank Transfer
If you wish to pay by bank transfer, you should drop an email to with the appropriate subject and the following details.
Name:
Mode of Payment: *ATM transfer / iBanking
*For ATM transfers, please email us a clear snapshot of your ATM receipt
Transaction Reference no:
Date & Time of transfer:
Amount Transferred:
The bank details are as follows:
Account Name / Oxford and Cambridge Society of Singapore
Account Type / DBS Current Account
Bank Name / DBS Bank Limited
Address of Beneficiary Bank / 12 Marina Boulevard, DBS Asia Centre, Marina Bay Financial Centre Tower 3, Singapore 018982
Bank Code / 7171
Branch Code / 118
Account Number / 118-901243-6
SWIFT Code / DBSSSGSG