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 The Artwright Community - Application

Membership Application Form

With The Artwright Community, understanding your needs and preferences means a lot to us. That's why you're the focus of this questionnaire. Please take a few moments to complete this form as it will help us to design programs and events that will be of interest to you.


My Personal Particulars

Name in full as in NRIC/Passport *

Mr. Mrs. Ms. Dr. Other

Name to appear on membership card *

Home Address :

Street
City/Town
Postcode

Country

Telephone (H)

Fascimile (H)

Email *


Correspondence Address (if different from above) :

Street
City/Town
Postcode

Country

Telephone (C)

Fascimile (C)

Email


NRIC/Passport Number

Nationality Race

Sex Marital Status

Birth Date (dd.mm.yyyy)

Hobbies and Interests :

Sports and Games

Cultural Activities

Leisure Activities


Employment Particulars

Company Name *

Type of Business / Industry

Position Held

Company Address :

Street
City/Town
Postcode

Country

Telephone (O)

Fascimile (O)

Email

l confirm that the above is true and complete. l agree to abide by the terms and conditions of the Artwright Community.

 

 

       

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