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Breastfeeding Mothers' Support Group (Singapore)

96 Waterloo Street #02-04 SCWO Centre, Singapore 187967
Tel: 339-3558 / 337-0508
Updated on Aug 02, 2001

 

APPLICATION FOR MEMBERSHIP

Please Print out the Form and Fill in your Details.
Then, mail the form together with your cheque to:

"Breastfeeding Mothers' Support Group (Singapore)"
96 Waterloo Street #02-04 SCWO Centre, Singapore 187967

Any queries, please direct to

postmaster@bmsg.org.sg



BREASTFEEDING MOTHERS' SUPPORT GROUP (SINGAPORE)

96 Waterloo Street, #02-04 SCWO Centre, Singapore 187967.
Tel: Counselling Line : 339 3558
Admin/ Talks Line : 337 0508
Fax Line : 337 0508
Email : postmaster@bmsg.org.sg
Web Page : http://www.bmsg.org.sg
 
 

MEMBERSHIP APPLICATION

Part A

I hereby apply for admission as a member and agree to abide by the constitution and rules of the Said Association.

Name: Mr/Mrs/Mdm/Miss/Dr ____________________________________________________________________

NRIC No :____________________________________ Citizenship :___________________________

Birth Date :____________________________________ Occupation :___________________________

Marital Status :____________________________________ Company :___________________________

Address :_______________________________________________________________________________

____________________________________________________Postcode :___________________

Home Tel :____________________________________ Office Tel :____________________________

Handphone :____________________________________ Pager :____________________________

Fax :____________________________________

Email :________________________________________________________________________________

Please indicate how you found out about the Group :____________________________________________________

Estimated Date of Delivery ( if applicable):___________________________

Obstetrician (doctor) :_____________________________ Paediatrician :___________________________________

Hospital baby was born in or going to be born at:______________________________________________________
 
 

Part B Spouseās Particulars

Name: Mr/Mrs/Mdm/Miss/Dr _______________________________________________________________________

NRIC No :____________________________________ Citizenship :____________________________

Birth Date :____________________________________ Occupation :____________________________

Company :____________________________________ Office Tel :____________________________

Handphone :_______________________ Pager:______________________ Fax:________________________
 
 

Part C Children's Particulars

Child's Name Sex Birth Date Duration of Breastfeeding

1. ________________________________________ ____ ___________ _____________________________

2. ________________________________________ ____ ___________ _____________________________

3. ________________________________________ ____ ___________ _____________________________

4. ________________________________________ ____ ___________ _____________________________
 
 

Part D Please refer to Membership notes below before completing

I / We are applying for: (Please tick where necessary)

Annual membership fees are payable in the first instance of joining and thereafter in January of each year.

Signature: _________________________________ Signature: _____________________________

Name in Block: _________________________________ Name in Block: _____________________________

Date: _________________________________ Date: _____________________________

(for 2nd applicant in husband and wife membership)
 
 

Cheques should be made payable to the "Breastfeeding Mothersā Support Group (Singapore)" and sent together with this application form to the address on this form.

Membership Note

  1. Full membership is open to women who have breastfed predominantly for at least 6 weeks.
  2. Associate membership is open to any individual who shares the conviction that breastfeeding is the best form of infant nutrition or to any women who are pregnant and are planning to breastfeed. (Pregnant applicants without prior breastfeeding experience will be admitted as Associate Members first, and will be converted subsequently to Full Membership after gaining breastfeeding experience)
  3. Full members or Associate members who are retirees shall pay a reduced subscription. If both husband and wife join the Group as members, they shall pay a discounted rate of S$40.00.
  4. All members shall have one vote each but only Full members shall be eligible to hold office.
  5. A Person wishing to join the Group shall submit an application on a prescribed form to the Secretary. Her application shall be considered by the Committee who shall decide by a simple majority vote in a committee meeting. A copy of the Constitution of the Group shall be provided to every approved applicant who has paid her first annual membership fee.

For Official Use Only

Membership valid until: ___________________________

Renewed until: _________________________________ Renewed until: __________________________

Renewed until: _________________________________ Renewed until: __________________________

Renewed until: _________________________________ Renewed until: __________________________

Renewed until: _________________________________ Renewed until: __________________________
 
 

FOR OFFICIAL USE ONLY
Cash/ Cheque No.
Receipt No.
Date  Paid
Handbook given
Husband & Wife Membership
Date  Verified
Membership No.
Membership type
Date passed
Date of expiration
Keeping Abreast
Date mailed out

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