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   Resident Information
* Name:
* Email:
* Blk No: * Unit No: # -
* Street Name:
* Telephone: Handphone +65
Office / Residential +65
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   Appointment Details
Appointment Date:      
Appointment Time:     2pm to 5pm
Item Description: 1.
By submitting this form, I agree that the Town Council may collect, use and disclose all information as contained in this form for the following purposes:
• to provide me with information as requested;
• to respond to enquiries made or purportedly made by me;
• to compile and analyse feedback for internal use only; and/or
• to contact me to request for more information where required.
I further agree that the Town Council may disclose any or all of such information to:
(i) its affiliates, service providers and agents for the above purposes;
(ii) public agencies for funding, reporting, statistical, research and survey purposes; and
(iii) the Member of Parliament for Bishan-Toa Payoh GRC for communication purposes.
I warrant that where I have disclosed personal data of other individuals in connection with this application, I have obtained the prior consent of such individuals for the Town Council to collect, use and disclose such data for the above purposes.