SPS AFFILIATE Membership Application Form – OverseasYou are here:HomeSPS AFFILIATE Membership Application Form – Overseas Affiliate Membership (Overseas)I have completed tertiary education.*YesNoTertiary Institution:*A. Personal Particulars(This form will require approximately 15mins to complete)Title*MrMrsMdmMissDrProfessorFull Name (as in NRIC/Passport)* First Last Alias / Other Name (if applicable):NRIC No / Passport No:*Date of Birth:* Place of Birth*Marital Status*SingleMarriedSex*MaleFemaleEthnicity*Nationality*Residential Address*Please fill in all fields House No / Block No Street Name City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Work Address*Please fill in all fields Same as previous House No / Block No Street Name City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone Number (Home)*Phone Number (mobile)*Phone Number (work)If applicablePhone Number (fax)If applicableEmail* Enter Email Confirm Email B. Education Qualifications(in chronological order) Document submission required (Section E)No. of Education Qualifications You Wish To Enter*Please enter a value between 1 and 5.1 - Qualification Attained (Please spell out in full)*1 - Start Date* 1 - Name of Institution & Country*1 - Date of Award / Expected Date of Completion* 1 - Accreditation Agency Full or Part-Time/Distance Education*2 - Qualification Attained (Please spell out in full)*2 - Start Date* 2 - Name of Institution & Country*2 - Date of Award / Expected Date of Completion* 2 - Accreditation Agency Full or Part-Time/Distance Education*3 - Qualification Attained (Please spell out in full)*3 - Start Date* 3 - Name of Institution & Country*3 - Date of Award / Expected Date of Completion* 3 - Accreditation Agency Full or Part-Time/Distance Education*4 - Qualification Attained (Please spell out in full)*4 - Start Date* 4 - Name of Institution & Country*4 - Date of Award / Expected Date of Completion* 4 - Accreditation Agency Full or Part-Time/Distance Education*5 - Qualification Attained (Please spell out in full)*5 - Start Date* 5 - Name of Institution & Country*5 - Date of Award / Expected Date of Completion* 5 - Accreditation Agency Full or Part-Time/Distance Education*C. Professional Association Memberships[If applicable] Document submission required (Section E)List of Membership in Professional BodiesYear AcceptedAssociation / SocietyMembership Category D. Employment History[If applicable] Document submission required (Section E)List of Previous EmploymentDate Started (DD/MM/YYYY)Date Ended (DD/MM/YYYY)Job Title / OccupationEmployer Name Please download Character Reference Form and attach below. Please ensure that the form is filled in. Download SPS Character Reference Form Here Please also provide your CV and resume and attach below.E. Document SubmissionPlease upload all supporting documents here. Do ensure that they are certified true copies. You may be asked to provide hardcopy documents where necessary.Please ensure that you have uploaded the following: 1. Documentation of Educational History (i.e., transcripts) 2. Documentation of Professional Association Memberships 3. Evidence of Employment (i.e., CV and letter of employment from current organisation) 4. 2 character reference forms 5. CV and resumeSubmit all supporting documents here* Drop files here or Areas of Interest in PsychologyPlease state areas of interest in Psychology*(Maximum 250 words)Please indicate ways in which you may like to contribute to the work of the Singapore Psychological Society*(Maximum 250 words)Privacy of InformationI consent to having the above information published in SPS Membership Directory.*YesNoDeclarationHave you been or are you currently under investigation by any disciplinary or legal tribunal?*YesNoHave charges of unprofessional conduct ever been brought against you?*YesNoHave you been convicted in the past 10 years of an offence involving a criminal charge or is there any charge pending?*YesNoI hereby declare that all information/documents submitted by me in this application is true and accurate.*YesNoI understand that any misleading statement, or omission may be cause for rejection of this application.*YesNoI hereby declare that pending acceptance and if accepted, I agree to be bound by the Constitution of the Singapore Psychological Society as amended in 2004 and the Society Code of Ethics.*YesNoPayment InformationPlease be reminded that payment of SPS membership fees should accompany this application. Do note that payment of an incorrect amount would lead to a rejection of this application. Please choose either payment through Manual (cash / cheque / Internet Banking / Giro) or Paypal (preferred mode). If cash payment is preferred, please do not submit cash by post. Contact the secretariat office (details below) to discuss suitable alternatives. **Please note that there will be an administrative fee of $30 for all applicants (local/overseas). For overseas applications, an additional $30 overseas fee for processing and postage will be charged. This is to be paid over and above the above stated membership fees.Payment Instructions: Paypal Please click submit and click on the Paypal option and follow the instructions provided. Cheque Payment Please issue a cheque made to payee: Singapore Psychological Society with respective payment amount. Please write your full name or membership number at the back of the cheque for easy verification. Internet Banking Payment A/C Name: Singapore Psychological Society A/C Number: 070-002366-0 Bank Code: 7171 Branch Code: 070 Swift Code: DBSSSGSG Giro Payment For Giro payment, please download the form below and send your completed form (hardcopy) to the secretariat office. Download Giro Form Here If paying by internet banking or PayPal, please indicate the transaction reference number and take a print screen of transfer amount made. Please also include your full name or membership number in the email / attachment for easy verification. Please send / or email all relevant documents to the following address: Singapore Psychological Society Secretariat Office 8 Eu Tong Sen Street #18-81 The Central Singapore 059818 Email: secretariat@singaporepsychologicalsociety.org Important Notes:(1) If you respond Yes to any of the above questions, please submit an explanation and/or details of the outcome. Mark it Private and Confidential and attention this to the Membership Committee. Please send your letter to the secretariat office above. In considering your application, the Membership Committee or Members of the Council of SPS may request further information. A Yes answer does not automatically mean a rejection of the application. Each application will be considered on its merits.(2) As part of the membership application process, all applicants need to be nominated by 2 current full members of the society, who must sign and provide his/her membership number on the nominators’ section above. Only applicants for international membership are exempted from completing this section of the form.(3) SPS will require transcripts to be mailed directly from the home institution. For local applications, certified true copies of transcripts/academic records will be accepted. Copies of supporting documents (Based on the information you provided for your academic qualifications, Professional Memberships & Employment) have to be certified true copies. Certified true copies mean photocopies stamped and signed as a true copy by the awarding university, awarding organization, Advocate & Solicitor, a Notary Public, a Justice of Peace or embassy ONLY.(4) The certifying officer must not be a family member or spouse. Please submit certified true copies of marriage/partnership certificate, deed poll etc., if your name is now different from that on the certificates. Please note that we will not accept copies of documents certified by staff of current/past employer(s).(5) SPS will email you on receipt of your application. Please arrange for the payment of your processing fee by PayPal,Internet Banking, cheque made payable to ‘Singapore Psychological Society’ or Giro Payment.(6) You will be given your reference code to check the status of your application. Please retain your reference code should you require our assistance.
