Membership – Eurasians Forms

*Use one form per applicant. Please complete all relevant sections. All entries are to be done in BLOCK letters. (* Tick appropriate box)

By submitting this form, you consent to the Eurasian Association’s collection, use and disclosure of your personal data to process this membership. Your personal data may be disclosed to EA’s employees, membership sub-committees, volunteers and third parties to provide you membership services. For more information, refer to EA's Privacy Policy.
Please do not attach your NRIC for Personal Data Protection.

APPLICANT’S PERSONAL PARTICULARS

Salutations *

First Name *

Surname *

House / Block No. *

Resident Address / Street Name / Development Name *

Floor No. *

Unit No. *

Postal Code *

Sex *

Date of Birth *

Home No.

Mobile No. *

NRIC No. (First & Last 4 characters) *

Race * Race

*Definition of Eurasian:
- Who is of both European and Asian ancestry; or
- Whose family has been accepted as Eurasian by custom and tradition

Occupation *

Email *

Marital Status * Marital Status

Spouse’s Name *

Contribute in Some Other Way

MEMBERSHIP CATEGORY

Membership List

Life Membership for Eurasian Seniors 60+ (Waived)

Life Membership ($60) - Eurasian SCs & PRs only

Ordinary Member ($12 p.a) - Eurasian SCs & PRs only

Eurasian Singaporeans & Permanent Residents Only
*For Eurasian Community Fund (ECF) contributors, please opt for Life Membership.

Associate Life ($60) - Non-Eurasian SCs & PRs

Associate Ordinary ($12 p.a) - Non-Eurasian SCs & PRs

Associate International ($60)

Eurasians who are neither Singaporean nor PR who may or may not be resident in Singapore, may apply for Associate International Membership

Junior (<18 Years Old) (Waived)

EA Staff will be in contact with you to verify your NRIC

EURASIAN COMMUNITY FUND CPF – MONTHLY CONTRIBUTION

Yes / No *

Yes

No. of Years (Contribution to ECF) *

Years

File Upload (ECF contribution proof or past 3 months payslip or any other supporting documents other than NRIC)
Please remove salary amount and leave your contribution amount for verification *

Maximum file size: 20MB

File format supported - pdf, doc, png, jpeg, bmp

FOR ASSOCIATE LIFE & ORDINARY APPLICATIONS ONLY

Reason for Application / Name of Introducer (If any) *

FOR JUNIOR APPLICATIONS ONLY

Name of Parent/s

Father

Mother

Applicant’s School / Institution

Level

Year

PAYMENT

Payment Type *

Cash

Cheque

Bank Transfer

Amount payable

Bank / Cheque No

To make payment by cash, please head down to our office at:
139 Ceylon Rd, Singapore 429744
Tel +65 6447 1578

To make payment by cheque:
Please make your cheque payable to ‘The Eurasian Association’

Address:
139 Ceylon Rd, Singapore 429744

I,hereby confirm that I understand and agree to all provisions in this form.

Applicant’s Signature *

Clear

If you are human, leave this field blank.

Membership Application

Name of Parent/s

Parent's Membership Category

Applicant’s School / Institution

About

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