Credit Counselling Singapore

* My Name:

* NRIC No. (S1234567A):

Gender:

Male Female

Marital Status:

Age Group:

* Mobile No.:

Home No.:

Office No.:

* Email Address:

Note: Please provide a valid email address for us to send a reminder.

* Home Address:

* Postal Code:

Outstanding Unsecured Debt:

Number of Unsecured Creditors:

Monthly Income:

How did you get to know CCS?

*No. of person(s) attending the free info talk:

My partner's Name: Parner's IC:

Note:
Please ensure to register all parties attending. It there is more than one person coming with you, please have the other person(s) register themselves, otherwise there will be seating problem

Choose date to attend the free info talk:

Select	Date / Day	Time	Language	Vacancy	Location	Remark
	16-03-2010 (Tue)	7 pm - 9 pm (Door will be closed at 7:15 pm)	English	0	CCS office, #12-01 Maxwell House, 20 Maxwell Road click to View map	Nearest MRT: Tanjong Pagar & Chinatown (Please be seated at 6:55 pm)
	27-03-2010 (Sat)	2 pm - 4 pm (Registration & Refreshment starts at 1:30 pm. Talk starts at 2 pm. Door closed at 2:15 pm)	English	91	NVPC office, #04-88 The Central, Eu Tong Sen Street click to View map	Nearest MRT: Clarke Quay (Please be seated at 1:55 pm)
	31-03-2010 (Wed)	7 pm - 9 pm (Door closed at 7:15 pm)	English	5	CCS office, #12-01 Maxwell House, 20 Maxwell Road click to View map	Nearest MRT: Tanjong Pagar & Chinatown MRT (Please be seated at 6:55 pm)

Note:
You can register for one date only. If you can’t attend the talk date you have registered for, you have to cancel the registration before registering for a new date.
Please be seated 5 minutes before the Talk Time stated.