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Northern Lights Malta C.H.R.A 005       Membership Waiting List 
By completing this form, you are indicating your request for the waiting list to Northern Lights C.H.R.A. The provided information will be utilized to contact you as soon there is open space again to take new member to the club.

Email *
Name and Surname
 *
Date of birth (must be age 21+)
 *
MM
/
DD
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YYYY
Nationality  *
WhatsApp contact / Mobile number (We send you an Invite via WhatsApp) *
VALID ID card or Residence card number *
City of residence? (Must be living in MALTA to become a member) *
Do you have a valid Maltese Residence or Maltese ID Card? (Please note that by law, NO tourists are allowed to become members or to make any type of purchases)
 *
How frequent do yo use Cannabis? Please select an answer below.  *
How many grams of Cannabis flower do you consume per month?
Maximum is 50g per month. *
A copy of your responses will be emailed to .
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