Membership Form – Family – AUTOMOBILE ASSOCIATION OF SINGAPORE

REGISTRATION FORM

Personal Details

Salutation*

Gender*

Full Name as Per NRIC*

Occupation*

Last 3 digits + checksum of NRIC/FIN no.*

(E.g. "567A" from the full NRIC number “S1234567A”)

Date of Birth*

Nationality*

Race*

Email*

Mobile Phone*

Telephone

What is your marital status?*

REGISTRATION FORM

Residential Address

Postal Code*

ZIP / Postal Code

Block/House No.*

Street Name*

Building Name

Floor Level

Unit No.

Country*

REGISTRATION FORM

Driving License

Driving License No.*

Driving License Class*

Driving License Expiry Date

(Not applicable for Singaporeans)

Car Details

Registration No.

Brand

Model

Hidden

Colour

REGISTRATION FORM

Membership Registration Type

I would like to apply for:*

Family

Term and Gift*

Promo Code (If applicable)

Total

Details of Principal Member

Name*

AA Membership No.*

Applicant Relationship to Principal Member*

MEMBER-GET-MEMBER (MGM) PROGRAMME I 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.

Hidden

membership_expiry_date

Personal Details

Residential Address

Driving License

Car Details

Membership Registration Type

I have a account

I do not have a account