| Principal
Member's Particulars |
| Member Name |
|
| NRIC/ FIN / Passport No |
|
| |
|
| Supplementary
- My Personal Particulars |
| Full Name as in NRIC / Passport
|
|
| NRIC / FIN / Passport No |
|
| DOB (dd/mm/yyyy)
|
 |
| Nationality |
|
| Race |
|
| Gender |
|
| Marital Status
|
|
| Highest Education
|
|
| Residence Type |
|
| Residence Is |
|
| Home Address |
|
|
|
| Country |
|
| Postal Code |
|
| Relationship to Member |
|
| Home Telephone No |
|
| Mobile No |
|
|
Email Address
|
|
|
(Please note that all future correspondences or notices will be sent through
this e-mail address)
|
|
|
| Supplementary
- My Work |
| Company Name |
|
| Office Address |
|
| |
|
| Country |
|
| Postal Code |
|
| Office Tel No |
|
| Office Fax No |
|
| Job Status |
|
| Position |
|
| Length of Employment |
years
months |
| Gross Monthly Salary |
|
| |
|
| Supplementary
- My Driving Experience |
| Driver's Licence No. |
|
| Type |
|
| I qualified for my Driver's Licence in
(dd/mm/yyyy)
|
|
| Licence Country |
|
| During the past 12 months, I've driven
a vehicle independently for |
|
| Do you or your family own a car? |
|
| Other than a car, other means of
transport used frequently |
|
| Involved in road accidents ?
|
|
| Any Traffic Demerit Points ? |
|
| |
|
| Supplementary - In
Case of Emergency |
| Name |
|
| Relationship to Member |
|
| Emergency Home Telephone No |
|
| Emergency Mobile No |
|
| |
|
|
Declaration and Submission of Form
|
| Upon clicking the “Submit” button below, I/we
declare that all information stated herein are true and correct and hereby
authorise WhizzCar of Popular Rent A Car Pte Ltd to verify the information in
this application with any source that WhizzCar may consider appropriate. We
agree that the approval of this application is subject to WhizzCar’s own
discretion and that WhizzCar reserves the right to reject this application
without providing details and information to us.
(For Individual Supplementary Application) If
I/we have requested for a Supplementary Card to be issued. We accept that we
shall be jointly and severally liable for all charges incurred on the
Supplementary Card issued.
(For Corporate Supplementary Application) If I/we
have requested for a Supplementary Card to be issued. The Company shall be
severally liable for all charges incurred on the Supplementary Cards issued.
I/We agree to the
terms and conditions by WhizzCar where the said terms and conditions
can be obtained upon request, which will be sent to us via snail mail. I/We
agree that any use of WhizzCar’s Smart Card will constitute acceptance of the
said by-laws, terms and conditions of
membership and such variations as WhizzCar may from time to time make. I/We
hereby declare that I/We am/are not undischarged bankrupts.
|
|
|