Membership Application Form

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Category Applied For *

Gender *

Title *

Given Names *

Surname *

Preferred Name *

Date of Birth *

Mailing Address Street / Line 1 *

Mailing Address Street / Line 2

Mailing Address Suburb *

Mailing Address State *

Mailing Address Postcode *

Mailing Address Country (if overseas)

Residential Address Same As Mailing Address?

Yes

Residential Address Street / Line 1

Residential Address Street / Line 2

Residential Address Suburb

Residential Address State

Residential Address Postcode

Home Phone Number

Business Phone Number

Mobile Number

Occupation (if employed)

Email Address for Billing *

Email Address for General Correspondence *

Emergency Contact First Name and Surname *

Emergency Contact Phone Number *

Spouse/Partner First Name and Surname

School Currently Attending

Parent First Name, Surname and Contact Number

Do you have the details of your proposer and seconder? (Click Yes, if you know 2 Senior voting Members of the Club or No, if you would like to include referees not at the Club). *

Yes

Proposer Name

Proposer Email Address *

Seconder Name

Seconder Proposer Email Address *

Referee Name (This can be a friend, family member, neighbour, work colleague etc.)

Referee Email Address *

Second Referee Name (This can be a friend, family member, neighbour, work colleague etc.)

Second Referee Email Address *

Membership

Club Information

Publications

Regattas & Sailing Events

Upcoming Section Events

Upcoming Club Events

Functions

Marina

Boatyard

Trades & Contractors

← Back to Membership Section

Membership

Club Information

Publications

Regattas & Sailing Events

Upcoming Section Events

Upcoming Club Events

Functions

Marina

Boatyard

Trades & Contractors

Membership Application Form

← Back to Membership Section

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