SURF CASTING AND ANGLING CLUB OF W.A. (Inc.)
Application for Membership.
Membership type:- Single Family Associate Junior Concession Please circle one.
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Last Name |
First Name |
Preferred Name |
Date of Birth |
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Applicant's Name:- |
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Family members to be included in Family Membership, if required.
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Partner's Name:- |
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Dependent child 1:- |
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Dependent child 2:- |
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Dependent child 3:- |
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Dependent child 4:- |
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Address:- |
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Post Code:- |
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Home Phone:- |
Work Phone:- |
Mobile Phone:- |
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Fax:- |
Email Address:- |
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Occupation:- OK to make this known to Club Members ? < YES / NO > |
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Skills:- OK to make this known to Club Members ? < YES / NO > |
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Hobbies/Interests:- OK to make this known to Club Members ? < YES / NO > |
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What I expect to get out of this Club:-
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I hereby apply for membership of the Surf Casting and Angling Club of W.A. (Inc.) and enclose nomination fee of $10. Should this application be accepted, I agree to abide by the Constitution and Rules of the Club.
Signed: _______________________________________ Date: ____ / _____ / _____
Nominated By:-(Club Member) Name: _______________________ Signature ________________________
Seconded By:- (Club Member) Name: _______________________ Signature ________________________
Club use only. Nomination received: $ __10___ on __/__/__ Rct# ____ Treasurer ________________ Subscription received: $ _______ on __/__/__ Rct# ____ Treasurer ________________ Nomination Published in Reel Talk __/__/__ Committee Approved __/__/__ Acceptance Published in Reel Talk __/__/__ Welcomed at Meeting __/__/__ President: _______________ Badge/Constitution/Rules and Membership Card Presented __/__/__ Membership List updated __/__/__ Returned to Treasurer __/__/__ Action Complete __/__/__ HTML Version 7, 9 August 2004 |
Contact:- Secretary, PO Box 2834, Malaga WA 6944.
email surfcast@iinet.net.au
