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Application Form: 3-Year Membership (New) (Without Card)
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Fields marked with asterisk are compulsory)
Name
Email Address
Postal Code
Mobile Number (+65)
Date of Birth
Country
Singapore
Malaysia
Albania
Algeria
American samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and herzegovina
Botswana
Brazil
British virgin islands
British indian ocean territory
Brunei darussalam
Bulgaria
Burkina faso
Burundi
Cambodia
Cameroon
Canada
Cape verde
Cayman islands
Central african republic
Chad
Chile
China
Hong kong, sar china
Christmas island
Colombia
Comoros
Congo
Cook islands
Costa rica
Cote d'ivoire
Croatia
Cuba
Cyprus
Czech republic
Denmark
Djibouti
Dominican republic
Ecuador
Egypt
El salvador
Equatorial guinea
Eritrea
Estonia
Ethiopia
Falkland islands (malvinas)
Faroe islands
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran, islamic republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea (north)
Korea (south)
Kuwait
Kyrgyzstan
Lao pdr
Latvia
Lebanon
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia, republic of
Madagascar
Malawi
Aland islands
Maldives
Mali
Malta
Marshall islands
Martinique
Mauritius
Mexico
Micronesia, federated states of
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestinian territory
Panama
Papua new guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto rico
Qatar
Reunion
Romania
Russian federation
Rwanda
Saint-barthelemy
Saint helena
Saint kitts and nevis
Saint lucia
Saint-martin (french part)
Saint pierre and miquelon
Saint vincent and grenadines
Samoa
San marino
Sao tome and principe
Saudi arabia
Senegal
Serbia
Seychelles
Sierra leone
Afghanistan
Slovakia
Slovenia
Solomon islands
Somalia
South africa
South georgia and the south sandwich islands
South sudan
Spain
Sri lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian arab republic (syria)
Taiwan
Tajikistan
Tanzania, united republic of
Thailand
Timor-leste
Togo
Tokelau
Tonga
Trinidad and tobago
Tunisia
Turkey
Tuvalu
Uganda
Ukraine
United arab emirates
United kingdom
United states of america
Uruguay
Uzbekistan
Vanuatu
Venezuela (bolivarian republic)
Viet nam
Virgin islands, us
Yemen
Zambia
Zimbabwe
Others
Gender
Male
Female
Race
Select Race
Chinese
Indian
Malay
Others
Interest
Education
Gadgets & technology
Language
Toys & games
Children activities
Reading/lifestyle
Which store did you sign up from?
Select Store
Not Applicable
Bedok mall
Bras basah complex - pop@central
Bukit panjang plaza
Bukit timah plaza
Causeway point
City square mall (popular pals)
Clementi mall
Compass one mall
Heartland mall
Hougang mall
Junction 8
Jurong point
Lot one
Nex
Northpoint city
Oasis terraces punggol
Paya lebar quarter
Seletar mall
Tampines mall
The woodleigh mall
Tiong bahru plaza
Toa payoh hdb hub
United square
Vivocity
Waterway point
West mall
Westgate
White sands
Promo Code/Referral Code (optional)
I wish to receive marketing promotions /offers
and events information by: (please tick accordingly)
Email
SMS
Mail
None
Payment Method
I (as the applicant / on behalf of the applicant) hereby confirm that the information I have provided herein is complete and accurate. By signing up to be a Popular Member, I have read and accepted
POPULAR's Terms & Conditions
and
POPULAR's Data Protection Policy
. I hereby consent to the collection, utilisation, retention, disclosure and sharing of my Personal Data by POPULAR for the signing up/renewal of my POPULAR membership.
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