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MEMBERSHIP APPLICATION/RENEWAL FORM – AFFILIATE MEMBER
MEMBERSHIP APPLICATION/RENEWAL FORM – AFFILIATE MEMBER
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Notes:
This application/renewal form is to be used for Affiliate Members. Under Rule 4(4) of the SRA Rules, Affiliate Members are “insurance, reinsurance and related industry associations and other organisations that share common goals and interests with the Association and wish to enter into a collaborative relationship with the Association”.
In submitting this form, you are deemed to have read the Privacy Policy and have given consent for us to share and post some of the information provided in the form below, such as: company contact details, website URL, geographical scope of operations, representative’s name in the public or members’ areas of the SRA website at
www.sg-reinsurers.org.sg
.
Please complete the mandatory fields with
*
for administrative purpose.
COMPANY NAME TO BE DISPLAYED ON SRA's WEBSITE
COUNTRY
- Select -
ASEAN
-Brunei
-Cambodia
-Indonesia
-Laos
-Malaysia
-Myanmar
-Philippines
-Singapore
-Thailand
-Vietnam
North-East Asia
-South Korea
-Taiwan
-China
-Hong Kong
-Japan
-Macau
-Mongolia
-North Korea
Indian Sub-continent
-Bangladesh
-Bhutan
-India
-Maldives
-Nepal
-Pakistan
-Sri Lanka
Oceania
-Papua New Guinea
-Australia
-Fiji
-Guam
-New Zealand
Middle-east / Africa
-Palestine
-Qatar
-Saudi Arabia
-Syria
-Turkey
-UAE
-Yemen
-Bahrain
-Iraq
-Jordan
-Kuwait
-Lebanon
-Oman
EUROPE
-United Kingdom
COMPANY REGISTRATION NO. (For Singapore registered companies)
DATE OF INCORPORATION
OFFICE ADDRESS
Unit No
If Unit Number is 12-345, please type '1', '2', '-', '3', '4', '5'
If there are multiple units, please indicate with a / (e.g. 12-03/04/05)
If not applicable, enter '00-00'
Building Name
Postal Code
TEL
WEBSITE URL (e.g. www.sitename.com)
MAILING ADDRESS
Unit No
If Unit Number is #12-345, please type '1', '2', '-', '3', '4', '5'
If there are multiple units, please indicate with a / (e.g. 12-03/04/05)
If not applicable, enter '00-00'
Building Name
Postal Code
TYPE OF ORGANISATION
1. Industry Association
2. Professional Members’ Institute
3. Education/Training Institution
4. Others (Please specify)
Enter other…
NAME AND DOMICILE OF ULTIMATE PARENT COMPANY/ORGANISATION/COUNTRY (If not applicable, please state "N.A.")
If
not
applicable, please state "N.A."
AUTHORISED REPRESENTATIVES
SRA Website Administrator
SRA Website Administrator
Name
Designation
Nationality
Email Address
Chief Representative
Chief Representative
Name
Designation
Nationality
Email Address
Alternative
Alternate
Name
Designation
Nationality
Email Address
I confirm that all the information provided above is true and accurate, and consent to the use of the above information in the public and members’ areas of the SRA website.
I have read and understood the
SRA's Privacy Policy
with regard to the Collection, User, Disclosure and Safeguard of the personal infomation that I have provided above."
SRA's Privacy Policy
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