NEW FESTIVE PROMOTION If you are human, leave this field blank.Applicant ParticularsSalutation *MrMrsMsMdmDrGender *MaleFemaleName of applicant (as in NRIC)Surname (Last Name) *Given Name (First Name) *Last 3-digit + checksum of NRIC/FIN no. *(E.g. “567A” from full NRIC no. of “S1234567A”)Driving License No. *Block/House No. *Street Name *Building NameFloor LevelUnit No.Country *SingaporeUnited States (US)United Kingdom (UK)CanadaAustraliaAfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabwePostal Code *Date of Birth *Email Address *Mobile Phone *TelephoneNationality/RaceMarital Status *SingleMarriedDivorcedWidowedDriving Licence Class *22A2B33A3C3CA44A5I would like to apply for: *3-year@SGD2044-year@SGD2725-year@SGD340Note: All options come with $68 off for selected AA services and FREE Family Membership for your spouse or child(below 21 years old). Please fill up the fields below for your spouse or child(below 21 years old) for Free Family Membership. *Applicable for Spouse or child (below 21 years old) *Family Membership must run concurrent with membership of Principal MemberSalutationMrMrsMsMdmDrGenderMaleFemaleApplicant Relationship to Principal Member SpouseChild aged below 21Name of applicant (as in NRIC) Last 3-digit + checksum of NRIC/FIN no. (E.g. “567A” from full NRIC no. of “S1234567A”)Driving License No.Postal CodeDate of BirthEmailMobile NumberDriving Licence Class22A2B33A3C3CA44A5 MEMBER-GET-MEMBER (MGM) PROGRAMMEI have been referred by a friend who is a valid member.Referrer’s Name ( If applicable )Referrer’s Membership No. ( If applicable )Note:By providing the above information, you have agreed to be recommended by your referrer who may qualify for AA MGM Programme. Click here for the Terms and Conditions of the programme. DECLARATION & AUTHORISATIONI agree to the below Declaration & Authorisation Details on Declaration & Authorisation I have read and agree unconditionally to be bound by AA’s Constitution, Terms and Conditions, Service Policy and Privacy Policy. I understand that AA reserves the right to reject any application in its sole discretion without giving any reasons. I certify that the particulars and information furnished herein are true and accurate. I understand that my AA Membership e-card can be accessed from the AA Singapore App. I understand that for new application, my membership e-card details will be mailed to me within 10 working days upon successful payment. I understand that the Terms and Conditions, Service Policy and Privacy Policy are available on AA’s website. I understand that RAS is handled by AA’s subsidiary, AutoSwift Recovery Pte Ltd (“ASR”). I consent to ASR accessing, collecting, using and disclosing my personal information for the purpose of verifying my identity and membership with AA and in connection with the carrying out of such RAS. I also consent to ASR communicating with me for the purposes of carrying out the RAS. In order for me to enjoy insurance services available to AA Members, I consent to AAS Insurance Agency, a subsidiary of AA and its partners, assessing, collecting, using and disclosing my personal information which I have furnished to AA. I also authorise and give consent to AAS-Insurance Agency and its partners to communicate with me via post , email, SMS text messaging and/or telephone on any insurance product, service, benefit and /or promotion. When I participate in any contests, activities or events organised by AA, I authorise and give consent to AA, its subsidiaries and partners to use photographs and/or video images taken at contests, activities or events in which I have been captured. The image(s) may be published in any of AA’s communication materials and collaterals and also in connection with any of AA’s business partners’ publicity purposes. In order for me to enjoy additional membership services or benefits that AA may extend to its members from time to time, I understand and consent that approved third party service providers may use my information in order to render the services or benefits extended by AA. I authorise and give consent to AA, its subsidiaries and partners to communicate with me in respect to this application and membership services, including benefits, insurance, campaigns, promotions, activities and events via post, email, SMS text messaging and /or telephone. I reserve the right to opt out of such communications if necessary. Captcha *Submit