Temple Basin Membership Application
I wish to apply for the following membership of the Temple Basin Ski Club Inc. *
First Name (Primary Applicant) *
Your answer
Surname (Primary Applicant) *
Your answer
Other family members (if applying for a Family Membership)
Your answer
Date of Birth - (if applying for Junior Membership)
Junior members are those under the age of 18 years on 1 February 2017 and attending a primary or secondary school in the current year and must state their date of birth
MM
/
DD
/
YYYY
Postal Address *
Your answer
Contact Phone Number *
Your answer
Email Address *
Your answer
Nominated By: *
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Seconded By: *
Your answer
I wish to pay by *
After completion of this form we will email you an invoice (once availability has been confirmed) which will have the account number for internet banking and a PAY NOW button for credit card payment by PAYPAL.
Any additional comments
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