MEMBERSHIP APPLICATION
1st
Name:___________________________ Family
Name:___________________________
Occupation, and skills that might benefit the club
_________________________________________
Partner’s Name:______________________ Email:
______________________________________
Occupation,
and skills that might benefit the club
_________________________________________
Home Ph: ________________ Fax: _______________ Alternative Ph:
_________________
Address:
___________________________________________________________________
Mail Address: ________________________________Alternative
Contact____________________
Children: 19 years and under to be included in Family Membership:
__________________________________________ Year of Birth:
__________
__________________________________________ Year of Birth:
__________
__________________________________________ Year of Birth:
__________
Trailer Sailer
Launch Keeler Centerboard
Trailer Boat
Boat Name:
____________________________ Registration No: ________________
Boat Design: ____________________________ Parua Bay Compound Waiting
List?:
Please find attached payment
(This includes $63 entrance fee for Family and Senior Members)
Subscription
|
Sept-Aug |
Dec-Aug |
Mar-Aug |
June-Aug |
|
Family |
$234 |
$191.25 |
$148.50 |
$105.75 |
|
Senior |
$191.25 |
$159.19 |
$127.13 |
$95.06 |
|
Social/Associate
Crew/Student |
$42.75 |
$42.75 |
$42.75 |
$42.75 |
|
Corporate |
$427.50 |
$320.63 |
$213.75 |
$106.88 |
_____________________________ Proposer_____________________________
Seconder
The above wish to support this application for membership to the Whangarei
Cruising Club.
Accepted at the Executive Committee Meeting held on ____________________
PRIVACY ACT: This information will be held by the Whangarei Cruising Club
for administration and legal purposes. Members of the Executive Committee
will have access but there is no public distribution.
DISABILITY NEEDS: Please specify requirements that will assist you to
participate.
|
