MEMBERSHIP | smhs

MEMBERSHIP APPLICATION FORM

I would like to apply for membership in this category:

Individual Membership (S$20 entrance fee + S$30 annual subscription)

Corporate Membership (S$20 entrance fee + S$300 annual subscription)

Name : Prof/Dr/Mr/Ms

E-mail :

MCR Number

Date of Birth : DD/MM/YYYY

Organisation / Clinic Name :

Work Address:

Country of Practice :

Area of Specialty :

Work Tel :

Mobile # :

By submitting this form, I understand and agree to the society sending me updates and invitations relating to my membership in the society.

Membership is valid from January to December. If you join mid-year, the full annual fee will still apply as we do not offer prorated rates.

For members with a lapsed membership, please note that payment for the lapsed period is needed to maintain continuity. Otherwise, the membership will be processed as a new application.