• GeronTech Ambassador (GTA) Programme (Batch #5) Registration

    Volunteer To Empower Seniors With Gerontech

  • Completion of this form does not confirm or guarantee your placement for the GeronTech Ambassador programme. Shortlisted candidates will be notified to attend an interview by SG Assist.

    This programme is a sponsored programme and is free of charge to attend.

    Please note that you need to be 50 years old & above to qualify for the programme.

  • Format: 000000.
  •  / /
  • Format: 00000000.
  •  - -

  • MEDIA CONSENT & RELEASE

    There will be video, audio, and photographic recording during this event/workshop for outreach, advocacy, and publicity purposes. If you prefer not to be recorded, please inform the SG Assist team or videographer.

  • Consent to Recording and Use

    I understand that my participation (including interviews, images, voice, and likeness) may be recorded and used in written, video, or visual content (“Released Content”). I consent to SG Assist Pte Ltd using this content for purposes including outreach, education, advocacy, and publicity, particularly in support of caregivers, seniors, and persons with disabilities. I understand that this content may include personal experiences or perspectives I choose to share, which may relate to caregiving, health, or lived experiences.

  • Use Across Media Platforms

    I understand that the Released Content may be published on SG Assist’s channels, including websites, social media platforms (such as Instagram, Facebook, LinkedIn, and TikTok), and may also be shared with media partners. I acknowledge that: Content published online may be publicly accessible and viewable worldwide. SG Assist cannot fully control how third parties may share, repost, or interact with such content

  • Rights Granted

    I grant SG Assist Pte Ltd and its authorised partners the right to use, reproduce, edit, and distribute the Released Content for the purposes stated above. This consent is given without expectation of compensation.

  • Withdrawal of Consent

    I understand that I may withdraw my consent for future use of my content by contacting SG Assist. I acknowledge that: Content already published or distributed may not be fully withdrawn or removed. SG Assist will make reasonable efforts to stop further use upon request

  • Third-Party and Sensitive Content

    I confirm that I am voluntarily participating and sharing information of my own choice. I will not disclose personal information of others without their consent. Where I refer to or include identifiable individuals, I have obtained their permission

  • Legal Acknowledgment

  • Signature

  • Should be Empty: