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Member Registration Form
  1. Salutation(*)
    Please enter your Salutation
  2. Surname(*)
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  3. Given Name(*)
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  4. Name of Organisation(*)
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  5. Designation(*)
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  6. Email (Office/Personal):(*)
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  7. Mobile(*)
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  8. Highest Academic Qualification(*)
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  9. Photo of Applicant(*)
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  10. Entrance Fee(*)
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    *Not Applicable for Student Applicants and Campaign
  11. Type of Membership(*)
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  12. No of Years(*)
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  13. Methods of Payment(*)
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  14. Bank Transfer To: DBS Current Account (032-000971-9)
    For Cheque, payable to: Singapore National Institute of Chemistry
  15. Issuing Bank(*)
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  16. Transaction/Cheque Number(*)
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  17. Total Amount Payable (S$)(*)
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    *ONLY in SGD($)