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NUS University Lifeguard Corps Registration Form
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* Indicates required question
Full Name
*
Your answer
Gender
*
Male
Female
Matriculation Number
*
Your answer
NIRC / Passport No.
*
Your answer
Date of Birth
*
(DD/MM/YYYY)
Your answer
Mobile Number
*
Your answer
Home Number
*
Your answer
E-Mail Address
*
Your answer
Which course are you signing up for?
*
Lifesaving 1,2,3 ($90)
Bronze Medallion ($110)
Swimming Proficiency Level
*
Beginner
Intermediate
Advanced
Competitor
Have you had any lifesaving experience anywhere else before?
*
Yes
No
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