Registration Form

Membership type

  • Notes on Membership
    1. 1. Ordinary and Life Membership is open to persons with epilepsy.
    2. 2. Ordinary and Life Membership is open to all other persons who are interested in the cause of epilepsy and willing to subscribe to the objects of Epilepsy Care Group (Singapore).
    3. 3. Only active Ordinary and Life members who are above 18 years of age and who have been members of the Group for at least 12 months shall have the right to hold office in the Group.
    4. 4. Corporate Membership is open to all firms, companies, organisations and institutions in Singapore who subscribe to the objects of the Epilepsy Care Group (Singapore). Only two representatives are allowed for each corporate member. Such members have no voting rights and cannot hold office.
    5. 5. Any member may resign his membership by giving notice in writing to the effect and paying all monies due.
    6. By submitting this form, you are assumed to have read and understood the membership conditions of the Epilepsy Care Group (Singapore) [ECGS] and understand that ECGS reserves the right to decline an application without giving any reason and is not obligated to respond to any request form from an unsuccessful application.
 

My Particulars

 

Name of applicant (as in NRIC/Passport)

 

Medical Information (Strictly private and confidential)

  • You will receive an email where you can print the details of your submission to be attached to your payment for subscription and posted to the following address : MEMBERSHIP APPLICATION EPILEPSY CARE GROUP (SINGAPORE) Epilepsy Support Development Centre 26 Dunearn Road Level 2 Singapore 309423
 

Verification