Personal Application Form

Membership Details

Type of membership

My Personal Particulars

Full Name as in NRIC / Passport

NRIC / FIN / Passport No

Date of Birth
(dd/mm/yyyy)

Male

Female

Home Address

Country

Postal Code

Home Phone Number

Mobile Phone Number

Email Address

Payment Mode

My Work

Company Name

Office Address

Country

Postal Code

Office Phone Number

Office Fax Number

Job Status

Position

Length of Employment
years months

Gross Monthly Salary

My Driving Experience

I qualified for my Driver's Licence on
(dd/mm/yyyy)

During the past 12 months, I've driven a vehicle independently for

Do you or your family own a car?

Yes

In the Past

Never

Yes

In Case of Emergency

Full Name as in NRIC / Passport

Relationship to Member

Emergency Home Phone Number

Emergency Mobile Phone Number

Referral

How did you find out about WhizzCar?

Referring Member's ID / Promo Code / Others

Please attach and upload clear copies of the following documents (PDF or JPEG):
1) NRIC/FIN (front and back) & Driver�s license (front and back)
2) Proof of income (recent payslip, CPF contribution statement)
3) Selfie Verification (holding NRIC)

NRIC/FIN & Driver's License	< 2Mb
Income proof	< 2Mb
Selfie Verification	< 2Mb

Write the security code in the image above

Declaration and Submission of Form

Upon clicking the "Submit" button below, 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. I/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.

If I/We have requested for a Supplementary Card to be issued, I/We accept that I/We shall be jointly and severally liable for all charges incurred on the Supplementary Card 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 keyfob 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. I/We further declare that I/We are not involved in any unsettled legal suit. I acknowledge that the one-time entrance fee and monthly membership fee are required and not refundable once my application is processed and approved. The minumum commitment period is 12 months (not applicable for Whizz-Ezzy Membership).