MEMBERSHIP APPLICATION/RENEWAL FORM – ASSOCIATE MEMBER

Notes:

This application/renewal form is to be used for Associate Members. Under Rule 4(3) of the SRA Rules, Associate Members are defined as “corporations, organisations or individuals associated or connected with or interested in the insurance business or reinsurance business, including risk bearing companies that have ceased active underwriting operations, insurance and reinsurance intermediaries, loss adjusters, credit rating agencies, catastrophe modelers, actuarial, audit, legal and other consulting firms".
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.

FULL NAME OF COMPANY (Legal Name for billing purposes)

COMPANY NAME TO BE DISPLAYED ON SRA's WEBSITE

COUNTRY

COMPANY REGISTRATION NO

DATE OF INCORPORATION (of company in Singapore)

OFFICE ADDRESS

WEBSITE URL (e.g. www.sitename.com)

BILLING ADDRESS

MAILING ADDRESS

COMPANY STRUCTURE (Please select one)

1. Locally Incorporated Company

2. Branch of Foreign Company

3. Others (Please specify)

INDUSTRY SEGMENT (Please select as applicable)

1. Insurance

2. Reinsurance

3. Insurance/Reinsurance Broking

Others (Please specify)

AUTHORISED REPRESENTATIVES

SRA Website Administrator

Name

Designation

Nationality

Chief Representative

Alternate

OTHER CONTACT PERSONS

To ensure efficient communications, please provide names and contact details of persons with the following functional responsibilities who will be copied in official emails and circulars to your company.
Please provide contact details for ALL listed functional areas. Where applicable, you may name the same person for multiple functional areas.
Please note that the SRA Website Administrator will be your company's PRIMARY contact person for all SRA Website related issues. This email address will serve as your company's ACCOUNT ID. Hence, please ensure that this email address remains current as communications on maintenance matters, change/loss of Account ID and password, etc will be sent to the SRA Website Administrator.
If the email address for Personal Assistant is the same as that of SRA Website Administrator, please indicate as 'N.A.' for the former.

Personal Assistant

Personal Assistant:

Name

Designation

Underwriting matters

Underwriting matters:

Claims matters

Claims matters:

Financial/Accounting matters

Financial/ Accounting matters:

HR matters

HR matters:

Regulatory/Compliance matters

Regulatory/ Compliance matters:

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

Please advise whom we should contact in the event we require clarification on any of your responses above.

Contact Person:

Designation

Email: