APSTA Membership Application (Individual)

Personal Info

Formal Name in English
Formal Name in Chinese, if available
Preferred Name (How do you want other people to address you?)
Gender MaleFemale
Birthday

Nationality

Nationality SingaporeanAmericanAustralianBangladeshiBritishCanadianChineseFilipinoFrenchGermanHong KongerIndianIndonesianItalianJapaneseMalaysianMyanmarNew ZealanderPakistaniRussianSingaporeanSouth AfricanSouth KoreanSpanishSri LankanSwissTaiwaneseThaiVietnameseOther
If Other was selected, please specify your nationality

– If you are a Singaporean or Singapore PR, please provide NRIC number (last 4 characters)
– If you are not a Singaporean, please provide Passport Number or Local Government-issued Identification Card Number (last 4 characters)

Contacts

Home Address including Country and Postcode
Personal Email Address
Mobile Number with Country Prefix
WhatsApp ID / Number
WeChat 微信 ID / Number

Organization Info

Name
Position
Title Prof.Dr.Mr.Ms.
Addresss with Country and Postcode
Email Address

Additional Info / Message

Message Subject
Your Message

Applicant Declaration

I confirm that:

1. All information provided in this application is true, accurate and complete;
2. I agree to comply with the APSTA Constitution and applicable membership policies;
3. I understands that APSTA reserves the right to review and determine membership applications in accordance with its Constitution and membership policies;
4. I will notify APSTA of any material changes to the information provided in this application;

Declaration Confirmation Check Checked