Membership Form – Club Jervis Bay

MEMBERSHIP TYPE

1 YEAR ASSOCIATE CLUB MEMBERSHIP - $7.50
5 YEAR ASSOCIATE CLUB MEMBERSHIP - $30.00
ORDINARY/R.S. CLUB AND RSL MEMBERSHIPSL - $35.00
ORDINARY AFFLIATE CLUB AND RSL MEMBERSHIPS - $13.50

(ALL Applications for Sub-branch membership require separate membership forms and relevant documentation to be attached. Affiliate membership has to be approved by Sub-Branch. Only Service Personnel and Ex-Serviceperson’s may become members of the Sub-Branch.)

Title*

FIRST NAME*

SURNAME*

ADDRESS*

POSTCODE*

POSTAL ADDRESS

(IF DIFFERENT TO HOME ADDRESS)

DATE OF BIRTH

OCCUPATION

PHONE NUMBER

EMAIL

NEXT OF KIN

PHONE NUMBER

Do you wish to receive the following notices via email (note membership renewals are no longer mailed to members)

Renewal of membership notice
Club Newsletter
Gaming Material
Notices of General Meeting, including Annual General Meetings

Consent

I agree to the privacy policy.

I CERTIFY THAT I AM OVER THE AGE OF EIGHTEEN YEARS (18YRS) AND AGREE TO BE BOUND BY YOUR CONSTITUTION, AND ANY RULES, REGULATIONS OR BY-LAWS OF THE CLUB FROM TIME TO TIME IN FORCE AND I CONFIRM THAT I HAVE NOT BEEN PREVIOUSLY EXPELLED OR HAD A PREVIOUS MEMBERSHIP APPLICATION REJECTED FROM EITHER THIS CLUB, OR ANY OTHER CLUB,