Registered Address: 21 Tampines Avenue 1 Singapore 529757

Registered Address: 21 Tampines Avenue 1
Singapore 529757
Membership Application Form
Applicant’s Details
Name: Mr/Mrs/Miss/Mdm/Dr *
(as in Finance records)
Home Address:
Telephone No: (Home)
Telephone No: (Office)
NRIC/Passport No:
Singapore (
Telephone No: (Mobile)
TP iHRS Employee No (6 digits):
TP Email Address:
I hereby apply for membership to the Temasek Polytechnic Co-operative Society. I agree to conform to
the by-laws and subscribe for 100 shares at $1/- per share which I will pay in full.
Enclosed with this application is my cheque + for S$115.00.
(Cost of Shares: $100.00 & Non-Refundable Application Fees: $15.00)
Please write cheque payable to "Temasek Polytechnic Co-operative Society Limited".
Send the completed form and cheque to the Secretary of TP Co-op c/o Assistant
For Official Use Only
Amount Received
Bank / Cheque Number
Date Received
Number of Shares Approved
Date Approved
Signature/ Date
Membership Application Form Last Update: June 2013
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