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MEMBERSHIP

Please note that all sections must be completed in order for this application to be submitted to the committee.
Any application missing information will be deemed incomplete and therefore not to be considered.

In order to apply for membership you will need to include:

A Clear Recent Headshot


Proof of Age

(e.g. Drivers License, Passport or ID card). Applicants must be over 21 years of age.


This form will take around 10 minutes to complete and all information will be treated in the strictest of confidence.


personal details

PROOF OF AGE*

Driving License or Passport - Max file size 5mb

upload

Drag & drop or click to select the file you would like to upload. max file size 5mb

Contact details

Place of residence

Occupation & Company

YOUR PHOTO

A clear Photo of a recent headshot of yourself - Max file size 5mb

upload

Drag & drop or click to select the file you would like to upload. max file size 5mb

Your Interests

Please select all/any interests from the following:


Preferred food


Preferred drink


Preferred music


Are you a smoker?


Where would you like to be seated?


Top Three Visited Venues in Dubai

Social Media

Communications

REVIEW & SUBMIT
* Please fill all mandatory fields

review & submit

ABOUT US
First Name
Last Name
Gender
Nationality
Additional Nationality
Date Of Birth
Relationship Status
Age Proof
Contact details/Place of residence
Address Line 1
Town/City
State
Postcode/Zip Code
Country
Email
Mobile
Telephone
Occupation & Company
Occupation
Industry
Company
Photo
Your Interests
Interests
Preferred food
Preferred drink
Preferred music
Are you a smoker
Where would you like to be seated?
Top Three Visited Venues in Dubai
First Venue
Second Venue
Third Venue
Social Media
Facebook
Instagram
Twitter
Communication
Submitted Date

I HEREBY APPLY FOR MEMBERSHIP

I agree to be bound by the rules of Neera Private Members Club and any by-laws made or to be made in accordance therewith.


I am over 21 years of age.

Require Assistance?

If you require assistance, or you would like to complete your application offline, please email info@neeradubai.com and our team will be happy to help.