AA Drivestyle Membership



APPLICATION FORM


AA Youth Associate Membership

*Name of applicant (as in NRIC):
 Mr Mrs Ms

*Name to Be Printed on Card (max. 33 characters):

*NRIC/FIN:

*Driving Licence No.:

*Home Address:
Block/House No.: Unit No.: #
Street Name:
Building Name:
Postal Code:

*Email Address:

*Tel: (HP/PG) (H)

*Name of Institution:

*Date of Graduation (DD/MM/ YYYY):

Gender: Male Female

Marital Status:

*Date of Birth (DD/MM/YYYY):

Nationality/Race:

Driving Licence Class:
 2B 2A 2 3 3A 4 4A 5

*Mandatory fields

Member-Get-Member Programme:

Name of introducer (as in NRIC/FIN):
 Mr Mrs Ms

NRIC/FIN No. of introducer:

Email Address:

*Terms and Conditions apply

Membership Fees (All fees inclusive of 7% GST)
Category Entrance Fee Membership Fee Total
AA Youth Associate - 1-year $32.10
2-year $64.20


Enclosed is my cheque for the sum of S$

Bank / Cheque No.
(Please make cheque payable to AAS)

Please charge the sum S$ to my credit card

Amex Visa Mastercard Diners

Credit Card No.:

Expiry Date:

Note: A copy of your credit card slip will be mailed to your mailing address in our records.

Please send in a recent colour passport-size photograph and a copy of your matriculation card to: 336 River Valley Road #03-00 AA Centre Singapore 238366. Attention: Membership Department. (Please write your name and NRIC No. on the back of your photo).

Alternatively, you may also email your digital photograph and a copy of your matriculation card to us in JPEG (.jpg or .jpeg) or GIF (.gif) format to mem-photo@aas.com.sg, indicating in the subject title " Photograph/matriculation - (pls state your Full Name, NRIC or Fin #)".

DECLARATION

  • I have read through the AA Youth Associate Membership Terms and Conditions.
  • I understand that the AA Membership Terms and Conditions, and Service Policy will be sent with my permanent membership card and I agree to be bound by such terms and conditions upon receipt of the Card.
  • I agree unconditionally to be bound by the Association’s Constitution, rules and regulations, and understand that my application is subject to rejection without assigning reason or notice given.

Please do not submit twice.