Membership

House Number *

Main Member Information

Main Member Call Sign

Main Member Radio Channels TunedCh 1Ch 5Other

Prefix

First Name *

Middle Name

Last Name *

Main Member Known as *

Main Member Email Address *

Main Member ID Number *0 / 13

Main Member Cell *

Spouse/Partner Information

Spouse/Partner Call Sign

Spouse/Partner Radio Channels TunedCh 1Ch 5Other

Prefix

First Name

Middle Name

Last Name

Spouse/Partner Known as

Spouse/Partner Email Address

Spouse/Partner ID Number0 / 13

Spouse/Partner Cell

In Case of Emergency

Emergency 1 Name *

Emergency 1 Phone *

Emergency 1 Relation *0 / 15

Emergency 2 Name *

Emergency 2 Phone *

Emergency 2 Relation *0 / 15

Additional Persons Staying at Address

Additional Person 1 Name

Additional Person 1 Phone

Additional Person 1 Relation

Additional Person 2 Name

Additional Person 2 Phone

Additional Person 2 Relation

Additional Person 3 Name

Additional Person 3 Phone

Additional Person 3 Relation

Communication

Are you on a street WhatsApp Group? *YesNo

If not, would you be interested to be added to a street group?YesNo

Would you prefer to be on a "non-chat" lookout group? *YesNo

Preferred method of communication *WhatsAppSMSEmail

Medical

Medical Aid *YesNo

State or Private *StatePrivate

Allergens Member 1 Name

Member 1 Allergy

Allergens Member 2 Name

Member 2 Allergy

Allergens Member 3 Name

Member 3 Allergy

Other Medical Information

Questionnaire

Are you a member of the CPF Sector 1? *YesNo

If not, would you want to become a member?YesNo

Is your property connected to a security company? *YesNo

If yes, which company? *0 / 25

Do you want to be involved in SNW Patrols? *YesNo

Do you have any medical / first aid training? *YesNo

Do you have any skill to assist the SNW? *YesNo

If yes, which skill?0 / 50

Do you own a business that you would like to advertise on the SNW website? *YesNo

Join Sinoville Neighbourhood Watch Now

Main Member Information