1 Membership Application2 Check Off Authorisation Reference Code (Optional)PERSONAL PARTICULARSName* Full Name as in NRIC/Passport NRIC Number*Sex*MaleFemaleName to be printed on card*Date of Birth* Nationality*SingaporeanMalaysianResidential Status*Singapore CitizenPermanent ResidentEmployment Pass HolderRace*ChineseMalayIndianEurasianProfessional Qualification*DiplomaDegreePGDEMastersYear QualifiedMediumEnglishChineseMalayTamilCONTACT DETAILSTelephone (Office/Home)*Handphone*Frequently Used Email or MOE Email* Address* Street Address ZIP / Postal Code EMPLOYMENTDesignationPrincipalVice PrincipalH.O.DSubject HeadLevel HeadSenior TeacherMaster TeacherCoordTeacherAEDNIE TraineeDesignation*PrincipalVice PrincipalEducation OfficerAEDNIE TraineeMonthly Gross Salary$1000 - $1499$1500 - $1999$2000 -$2499$2500 - $2999$3000 - $3999$4000 - $4999$5000 & AboveSalary GradeDate Joined Service* School / Branch Attached To*NTUC FAIRPRICE MEMBERSHIPIf this section is not duly completed, your FairPrice rebates application will not be processed. I would like to be an NTUC FairPrice Member under the “Join-Now-Pay-Later” scheme. The first $23 of rebates must be accumulated within the first three years to pay for the 20 Shares (at $1 each) and $3 admin fee. I authorise NTUC FairPrice to credit my NTUC FairPrice rebates into my bank account*. I also understand that the maximum amount in Purchases at NTUC FairPrice Cooperative Limited entitled to rebate each financial year is S$6,000 – the rate will be declared at the Annual General Meeting of NTUC FairPrice Cooperative Limited each year. *The FairPrice rebates ($) will be paid to the following bank account.Account Holder’s Name*Name of Bank*Bank Account No.*FREE OTO BACK SOOTHER PROMOTION Yes, I would like to receive the free OTO Back Soother (Pay 6 months membership fees upfront). STU will be contacting you for more information. REFERRERReferrer’s Name(If you were referred by a STU Member, please indicate his/her name)We will be contacting you for more information.AGREEMENT NTUC Membership refers to a range of membership types depending on the work status of the individual. NTUC reserves the right to assign successful applicants to an NTUC affiliated union/Association. For a full list of affiliated unions/associations, please visit www.ntuc.org.sg. Upon approval, all members will automatically become a member of NTUC Club. For NTUC FairPrice membership, applicants will have to opt in. I agree to: Membership Fees# ($117 per year) Authorise STU/NTUC or its Agency to obtain Membership Fees (current fees being $9 per Month (Jan-Nov); $18 (Dec) from me in accordance with the prevailing rates of Union/Association subscriptions. A one-off entrance fee and monthly subscription will be deducted from salary upon the Check-off authorisation. Rules Observe all rules and regulations of NTUC, its affiliated unions/associations. NTUC Social Enterprises, by-law of NTUC’s cooperatives, and terms and conditions relating to membership benefits and programmes. Transfer Between Membership Types Authorise NTUC and its affiliated unions/associations to assign and transfer my membership depending on eliqibility and work status. Loss and Replacement of NTUC Plus! Card Make a payment of $3,00 to “NTUC Link Pte Ltd” for any loss or replacement of NTUC Plus! Card. Notice of Termination Give 6 months’ notice for termination of membership in writing. Collection, Use and Disclosure of Personal Data I consent to my personal data being collected, used and retained by NTUC and my union/association for the purposes of processing, administering and managing my membership. I acknowledge that the collection, use and/or disclosure of my NRIC number is necessary to accurately establish my identity to a high degree of fidelity in relation to "NTUC Gift", a group insurance policy exclusively for members of NTUC affiliated unions and associations; financial subsidies for skill upgrading and training under the Union Training Assistance Programme (UTAP) and an array of other services including but not limited to legal consultation, job placement and education grants. I consent to my personal data being disclosed amongst: NTUC and the affiliated union/association of which I will be a member for the purpose of managing my respective membership; and NTUC/affiliated union/association, the Employment and Employability Institute, and NTUC Social Enterprises for the purposes of managing and increasing membership benefits and privileges. I consent to be contacted by NTUC and my union/association via email, text messages, fax and/ or post for matters relating to employment and employability, industrial relations, training and education, social and recreation as well as to give my opinion feedback on such matters. For the purposes of industrial relations and employment-related issues. I consent to NTUC and my union obtaining my personal data and any relevant data relating to my employment from my company. I will also keep NTUC and my assigned union/association informed immediately of any changes to my employment status or personal particulars that affect my membership status and benefits. I understand that I am also applying for membership to the PLUS! Programme (“PLUS!”) administered by NTUC Link Private Limited (“NTUC Link”). I agree to abide by the terms and conditions of PLUS!, I acknowledge and consent to:- The collection, use and retention of my personal data by NTUC Link for the purpose of fulfilling, servicing and managing my PLUS! Membership; the disclosure of my personal data between NTUC/union/association and NTUC Link for the purposes of processing, servicing and managing my PLUS! Membership; the disclosure of my personal data by NTUC Link to its Linkpoints Partners/Merchants for the purposes of fulfilling, servicing and managing my PLUS! Membership; I further consent to be notified by NTUC Link on benefits and privileges pertaining to PLUS! Via email, text messages, fax and/or post; and I can visit www.plus.com.sg to manage my PLUS! Membership (including withdrawal of consent) after my successful enrolment to PLUS! For any enquiries on personal data protection matters, please email to email@example.com. Notes The one-off entrance fee is $25.00 (for teachers who join within 6 months of their posting from NIE, the one off entrance fee is $10.00). #The cycle repeats automatically for the following year. For the list of NTUC Social Enterprise, please refer to www.ntuc.org.sg. For full details of STU PDPA Policy, please refer to www.stu.org.sg. Information correct at time of printing. For Member-Get-Member PromotionReferrer Name Surname/Family Name Given Name ContactSchoolUnion CodeBranch CodeDate joined Union ACKNOWLEDGEMENT* I certify that all information provided by me is true and correct and I agree to abide and be bounded by the terms and conditions. AUTHORISATION FOR DEDUCTION OF UNION SUBSCRIPTIONSTO: PAYROLL & CLAIMS MINISTRY OF EDUCATION 1 NORTH BUONA VISTA DRIVE SINGAPORE 138675 THROUGH: THE GENERAL SECRETARY SINGAPORE TEACHERS’ UNION 583 SERANGOON ROAD SINGAPORE 218197 I, the undersigned, a member of the Singapore Teachers’ Union, request and authorise you to deduct from my monthly salary and/or annual supplement, as the case may be, such union dues as are payable by me in accordance with my Union’s Constitution and as are notified to you from time to time by my Union and to remit the same to my Union. This authorisation is valid from 24/08/2019. If I wish to stop such deduction, I shall inform you in writing through my Union giving you six months advance notice. SIGNATURE OF MEMBERCAPTCHANameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.