APPLICATION FOR MEMBERSHIP OF ONEHUNGA RSA

Download Membership Form

Name*
Christian name Surname
Are you or have you been known by any other name?
- Yes
- No
If yes what?
Address*
Occupation*
Contact Telephone*
Date of Birth*
Email Address*
Have you membership ever decline, suspended or revoked from any Club
- Yes
- No
If yes Name of Club and Details
Privacy Act 1993
The above named club is collecting and will hold the information on this form The club is collecting the information

A. So it and its members can assess the applicants suitability for membership (including transfers of membership)

B. So it can administer its operation and assist other clubs that are members of New Zealand Chartered Clubs Incorporated (1,13ZCC) or Royal New Zealand Returned Services Association (RNZRSA) to administer theirs

C. To enable NZCC or RNZRSA or their agents to compile a list of members of all clubs in New Zealand and to send most members promotional marketing and other material

1. The applicant acknowledges by signing this form that he or she has authorized the club to obtain, check, exchange information with, and supply information to, members of the club, N1CC, RNZRSA and other member clubs

2. The applicant is entitled under the privacy act 1993 to have access to, and request correction of personal information held by the Club about the applicant

3. Parts of this form may be displayed on the new members board during the notice period.

I hereby agree to abide by the rules of the club and certify that the above information is correct. I acknowledge that if I have given false information, it will result in automatic cancellation of membership.
I wish to receive information in c above*
- Yes
- No
Signature of Applicant
Date
Date Format: MM slash DD slash YYYY
Nomination or membership fees are payable upon application of this notice.

Nomination fees are non refundable.

We know the applicant and in accordance with rules recommend him/her for membership
Proposer PRINT
Card number
Signed
Seconder PRINT
Card number
Signed
Not required for transfers
Office
Date received
Date Format: MM slash DD slash YYYY
Date elected declined
Date Format: MM slash DD slash YYYY
Subscription paid
Receipt no.
Mem No.

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APPLICATION FOR MEMBERSHIP OF ONEHUNGA RSA

Privacy Act 1993

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