CASE STUDENT MEMBERSHIP FORM
I like to apply for admission as a Member of Consumers Association of Singapore and agree to abide by the
Constitution & Rules of the Association
Mr/Ms/Mdm: ________________________________________________________________________________
Residential Address: ____________________________________________________________________________
Singapore (
) E-mail Address: _________________________________ Gender: ___________
Tel (Home):___________________(Office):______________________ (Mobile): ________________________
Preferred Contact No: _________________ Fax No: ________________ Date of Birth: ____________________
NRIC/ FIN NO: ____________________ Nationality:____________________ Marital Status:________________
Academic Qualifications: ___________________________ Occupation: ________________________________
Interests: _______________________________________
Please tick the subscription rate you prefer
Payment Mode: Cheque: ( ) Cash: ( ) Visa: ( ) Nets: ( )
1 yr
$8.56
2yrs
$17.12
3yrs
$25.68
Please tick here to receive C@sebites, our bi-weekly e-publication.
Note: Please submit a copy of your student pass/ matriculation card for verification. Membership fee paid is
GST inclusive and is non-refundable.
Please print out the application forms and send the completed form to us with a cheque payable to CASE on the
respective fees. All membership application are subjected to approval. Please note that as per our Constitution,
membership fees paid are not refundable.
__________________________________
Signature of Applicant / Date
OFFICIAL USE
Receipt No. __________________Date of Approval _________________
* To delete if it is not applicable
**Cheques should be made payable to CASE. CASE reserves the right on approval of membership