CaregiverCircle Registration Form

CaregiverCircle Registration Form

A community that speaks care. The landscape of caregiving in our society presents unique challenges for both family caregivers. At SG Assist, we have witnessed the tremendous dedication and sacrifice of these unsung heroes who provide care to loved ones. However, we recognise that caregivers often face isolation, limited resources, and the need for comprehensive support. Please note that only Singaporean citizens, Singapore permanent resident or holders of valid Singapore employment pass or work permit, with a valid NRIC/FIN will be eligible for the complimentary insurance. Foreign domestic workers and construction workers are not eligible.
Date

DayMonthYear
Date
Membership Expiry Date
Personal Details
Full Name as in NRIC*
NRIC Number*
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemale
Block Number / House Number*
Street Name*
Provide the official street name. Avoid abbreviations.
Floor and Unit Number *
Please include both floor and unit number for apartments. If you live in a landed property or other housing type without a floor or unit number, please enter 'NA' or 'Nil'.
Postal Code*
Enter your 6-digit postal code.
Contact Information
Mobile Number*
Please enter a valid phone number.
Email*
example@example.com

Personal Data Protection Act (PDPA) Consent

By completing and submitting this form, you're providing explicit consent to SG Assist in accordance with Singapore's Personal Data Protection Act (PDPA). Please read and understand the statements below:

Data Collection & Use:

I grant SG Assist permission to collect, use, and retain my personal data, as provided in this form, for the purposes of:
- Processing my membership application.
- Managing my membership and its associated benefits.
- Sharing updates and news related to SG Assist's membership programme.
Data Sharing with Third Parties:

I agree that SG Assist may disclose my personal data to third-party vendors, partners, or service providers for purposes related to the membership programme and its benefits.

Marketing Communications:

I consent to receive marketing, promotional, and event-related messages from SG Assist and its partners through channels like email, SMS, and other platforms.

Data Accuracy:

I confirm that all my personal data provided to SG Assist is accurate, up-to-date, and complete. I'll notify SG Assist of any changes.

Withdrawal of Consent:

I understand that I can opt out and withdraw my consent at any time by contacting SG Assist. I'm aware that this might affect the services and benefits available to me.
I've read and agree to SG Assist's Data Protection Policy. I confirm my understanding and agreement to the above statements.*

Yes, I give my consent.
Should be Empty:

Personal Data Protection Act (PDPA) Consent