CONFIDENTIAL
Please
attach
PEOPLE’S ASSOCIATION two
photographs
VOLUNTEER REGISTRATION
For Residents’ Nomination Scheme Nominee
Name of Committee
Name as in NRIC (underline surname) Name in Chinese Character
*Dr/Mr/Mdm/Mrs/Miss (if applicable)
NRIC No. Race Title of National Day Award &
Year Awarded (if any)
Sex Male Female
Date of Birth (dd/mm/yy) Marital Status
Nationality NS Status (if applicable) Language/Dialect
Full Time Written _______________________
Country of Birth
Reservist Spoken _______________________
Singapore PR *Yes/No/NA Exempted Religion
Home Address __________________________________________________________________________
______________________________ Postal Code ___________ E-mail Address ____________________
Home Telephone No. _______________________ *Pager/Handphone No. ____________________
Type of Dwelling
HDB_____ - Room Private Housing _______________________ (please specify)
Occupation Name of *Employer/Company (please specify if you are self-employed)
Workplace Address _______________________________________________________________________
______________________________________________ Postal Code ______________
Workplace Telephone No. _____________________________ Fax No. ___________________________
Highest Educational Level Attained _________________________________________________________
PROPOSER
Name as in NRIC * (Dr/Mr/Mdm/Ms) NRIC No
Home Address
Reason(s) for nomination Signature/Date
SECONDER
Name as in NRIC * (Dr/Mr/Mdm/Ms) NRIC No
Home Address Signature/Date
FOR OFFICIAL USE
Endorsed by:
Position Recommended ___________________
Recommended by: _______________________ _______________ ___________________________
Name & Designation Signature & Date Signature of Adviser & Date
*Delete as necessary
Note for RNS Nominee
1. Nominee must be Singapore Citizen or Permanent Resident who is 18 years old and above.
2. Proposer and Seconder must be residents who are 18 years old and above from different families of
the RC zone.