National Silver Academy Course 2018: The Art of Classical Chinese Poetry Online Application Form

PERSONAL PARTICULARS

1. Full Name (Name as appears in your NRIC)
2. Family Name/ Surname/ Last name
3. Gender 3. Gender
4. Race 4. Race
5. NRIC number
6. Email Address (Please kindly provide an email address that you frequently check)
7. Date of Birth (DD/MM/YYYY)
8. Country of Birth
9. Nationality/ Citizenship
10. Home Telephone Number
11. Mobile Telephone Number
12. Mailing Address 12. Mailing Address

EMERGENCY CONTACTS

14a). Next-of-Kin Full Name
14b). Relationship of Next-of-Kin to you (e.g. Spouse, daughter, son etc)
14d). Next-of-Kin's Contact Number (Mobile Telephone Number)

MISCELLANEOUS

30a). Do you have any special dietary requirements or allergies? 30a). Do you have any special dietary requirements or allergies?
30b). If yes, please kindly list them out.

ACKNOWLEDGEMENT

Important Note:

By filling up this application form, I hereby consent that my personal data provided in this form may be collected, used, processed and disclosed by NUS for the purpose of processing my registration, in accordance with the Personal Data Protection Act 2012 and all subsidiary legislation related thereto. In respect of disclosure, I understand that NUS may disclose my personal data to third parties (which may be in or outside of Singapore) where necessary for such purposes.

I understand that photography and videography may be conducted during the event and I consent to NUS taking photographs and videos of myself and in using the same for the purposes of event reporting, marketing, publicity, and media/ social media. I further consent to NUS disclosing such photographs and videos to third party media entities (whether in Singapore or otherwise) for publicity purposes.

36. Please check the box before submission. 36. Please check the box before submission.

Thank you for your submitting your application. You will hear from us sometime in October via email. Have a lovely day ahead!

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