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Membership Application


Joining Fees: Requirements:
One-time registration fee: $100
Monthly membership fee: $21.40 (first 2 months) [?]$10.70 payable monthly from the 3rd month
Total (incl. GST): $121.40
A refundable deposit of $100 is required.

Age 25 years or above and holds a Class 3/3A driver licence for at least 24 months (from the pass date)

PLEASE TELL US ABOUT YOURSELF

Salutation:

Surname (as in NRIC/Passport):

Given Name (as in NRIC/Passport):

NRIC/FIN:

Gender:

 Male Female

Date of Birth:

Email Address:

Mobile Number:

Marital Status:

Nationality:

Home Address:

Postal Code:

DO SHARE WITH US YOUR DRIVING EXPERIENCE

Driving Licence pass date:

Country of Licence issued:

License Class:

 2B     2A    2    3    3A     4    5

Which statement best describes your driving skills?:

How did you acquire your driving experience?:

If you own, have owned or your family owns a car:

Car plate number:

Number of years owned:

MY WORK INFORMATION

Name of Current Employer:

Position Held:

DECLARATION

Have you ever applied for membership and was declined or had your membership terminated by other car-sharing company?
Yes        No

If yes,please specify

Are you an undischarged backrupt, or presently undergoing proceedings to be declared bankrupt?
Yes        No

If yes,please specify

Have you been involved in a traffic accident, minor or major, while driving a car in the past 24 months?
Yes        No

If yes,please specify

Do you presently have any demerit points from the Traffic Police?
Yes        No

If yes,how many

 Demerit Points

If yes, what were the traffic offence?

AND FINALLY, DO TELL US...

How did you know about the Car Club?
If others, please specify:

Promotion Code (if any):

I have read the Terms & Conditions and declare that the information given in this application is true and correct. I authorise the Car Club to verify the information with any source as it may consider appropriate.
If I am accepted as a member, the information shall form part of the agreement and I agree to be bound by the Terms & Conditions of Membership.



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