Membership Application – Associate Member – The Singapore Police Co-operative Society Ltd

Please note:

Signature is required for all application forms.
Please print and sign on the hard copy after clicking on the ‘Submit’ button.
A copy of the completed Individual Tax Residency Self-Certification Form has to be submitted together with the Membership Application Form. A copy may be printed here.
All membership applications are to be submitted by the applicant personally to our office
together with the required documents.

Alternatively, you may print a blank form and complete them manually here.

"*" indicates required fields

Note: This form must be submitted together with the Original copy of Interbank GIRO Application Form

Select one only

Retiree

Affiliate

NSmen

SECTION 1 - PERSONAL PARTICULARS

Full Name (As in NRIC)*

Personnel No*

An 8-digit number

NRIC / FIN No. (Please Include Prefix S, T, F or G)*

Enter your full NRIC number

Nationality*

Race*

Chinese

Malay

Indian

Eurasian

Other

Gender*

Male

Female

Contact No. (Mobile)*

Contact No. (Home)

Contact No. (Office)

Date of Birth (dd/mm/yyyy)*

DD slash MM slash YYYY

Residential Address (As in NRIC)*

Mailing Address (If different from residential address)

Email Address (Personal email preferred)*

Name of Bank / Branch*

Bank Account No.*

SECTION 2 - CURRENT EMPLOYMENT DETAILS

Name of Employer*

Designation*

Gross Monthly Salary*

Employment Type*

Contract

Full-Time

Part-Time

Other

Date of Employment (dd/mm/yyyy)*

DD slash MM slash YYYY

SECTION 3 - MONTHLY SAVINGS CONTRIBUTION | OBLIGATORY DUES

Compulsory Monthly Contribution: SUBSCRIPTION (Min. $40, Max. $200)*

Please enter a number from 40 to 200.

First deduction (Amount = a + b +c) will commence two months after submission of complete set of application documents and shall include the following:

a) 150 Share Capital @ $1.00 Each - $150 (one-time)
b) Entrance Fee - $20 (one-time)
c) Your indicated Subscriptions Savings amount

Subsequently, only (c) will be deducted monthly.

Optional Monthly Contribution: SPECIFIC DEPOSIT (Min. $10, Max. $500)

Please enter a number from 10 to 500.

Please attach your latest payslip if total savings (including Subscription Savings) exceeds $500/month

Please enclose the following documents for the processing of the application:

A copy of my NRIC (front and back);
A copy of my latest payslip (optional);
A copy of my bank book / statement - front page with my name and account number (preferably POSB / DBS bank account);
A copy of the completed Individual Tax Residency Self-Certification Form; and
A copy of the completed Interbank GIRO Application Form (Original).

I declare that :

I am 16 years of age or above;
I am a citizen of Singapore or resident in Singapore;
I am not an undischarged bankrupt; and
I am not convicted of an offence punishable with imprisonment.

I understand that this application is subject to acceptance by the Society. The Society reserves the right to decline my application without assigning any reason thereof.

I agree that upon acceptance of this application by the Society, I will pay all monies due, including all monthly payments/instalments, in accordance with the By-Laws.

I will abide by the Co-operative Societies Act, Rules and By-Laws of the Co-operative.

I am fully aware that I am not permitted to exercise any voting power and to stand for election during the Annual General meeting or Extra-Ordinary General Meeting.

I have read and understood the Co-operative’s Privacy Statement (available on Police Co-op’s website – https://www.policecoop.org.sg). I hereby consent to the Co-operative collecting, using and disclosing my personal data for the purposes set out therein, in particular, to the processing of my membership application form and supporting documents pursuant to the provisions of the Co-operative Societies Act 1979 and to the disclosure of my personal data in accordance with the Personal Data Protection Act 2012.

SECTION 4 - REFERRER PARTICULARS ($25 PROPOSER INCENTIVE PROGRAMME)
(To skip this section if there is no referrer for this application)

Full Name of Referrer (As in NRIC)

Only existing Police Co-op members may be a referrer

NRIC / FIN No. of Referrer

Enter the last 3 digits + last alphabet of your NRIC. E.g. use “567A” if the NRIC number is S1234567A

Division / Unit

How did you hear about us?
(Please tick (✔) whichever is applicable. You can tick more than 1 option.)

Please Select

Referred by an existing Police Co-op’s member ($50 Proposer Incentive Programme)

Came across Police Co-op’s posters broadcasted via email (internal organisation network / intranet)

Social media (Police Co-op’s Facebook Page)

Word-of-mouth (through a colleague / family member / existing member / etc.)

I attended a membership talk conducted by Police Co-op

Others

Please Specify

Last Updated on July 1, 2023