Podiatry Association (Singapore) Membership Application
(i) Your membership application is subject to approval by the Podiatry Association (Singapore). Further verification of information may be required. (ii) Items marked * are compulsory data fields (iii) You may make membership payment only after your application has been approved via email (iv) Do check that your details are correct prior to submission.
* Required
Email address
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Form Category
*
New application
Membership renewal
Membership type
*
Full membership
Associate membership
Student membership
Gender
*
Female
Male
Marital Status
Your answer
Last 3 digits & alphabet of NRIC/FIN/Passport (eg. 333F)
*
Your answer
Nationality
*
Singaporean
Singapore PR
Other:
Required
Date of birth
*
MM
/
DD
/
YYYY
Kindly verify your date of birth in free text form eg. 12 July 2000
*
Your answer
Mailing address (pls include postal code)
*
Your answer
Contact number
*
Your answer
Race
Your answer
Religion
Your answer
Dialect group (If not applicable, state “N.A.”)
Your answer
Professional qualifications
*
Your answer
Name of University/institution
Your answer
Name of current employer/company
*
Your answer
Designation in current employer/company
*
Podiatrist
Senior Podiatrist
Principal Podiatrist
Other:
Address of current employer/company
*
Same as mailing address
Other:
State present membership in other registered societies in Singapore, and if an officer, indicate the title of office held and whether earning income from holding that office
Your answer
*
As an allied health professional in Singapore and a member of the Podiatry Association Singapore, I agree to uphold the Allied Health Code of Professional Conduct (the Code)
Required
*
I have read the Code (
http://www.healthprofessionals.gov.sg/content/hprof/ahpc/en/leftnav/code_of_ethics.html
)
Required
*
I do not have recent (3 years) or ongoing professional or disciplinary review(s) relating to my work as a podiatrist
If you do, or think you do, please reach out to our public relations officer or any of our officers after submitting your application.
Required
*
The above information given by me are true and correct and that I have not wilfully suppressed any material fact. I will keep the Podiatry Association (Singapore) informed of changes in relevant information & professional standing
Required
*
I give consent to Podiatry Association (Singapore) for collecting and using my data provided above to purposes of operations, management (including statistics) and maintaining contact.
Required
Send me a copy of my responses.
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