Application for Membership Form 2019
To join the club, or to renew your membership, please complete this form and separately submit the membership fee. Please note that renewals should also complete the form in full; this ensures that we always have up to date information, including emergency contacts.

Contact information in this section is required, and is used only for club-related correspondence. For example, the email address supplied is used to inform members of upcoming general meetings, the postal address is where we send the membership card, and the phone number is what we use when we need to get in touch with a member quickly.

Email address *
Is this a new membership or a renewal? *
First Name *
Your answer
Surname *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
National Identity Card Number *
(or equivalent, where ID card not available)
Your answer
Address *
Your answer
Phone *
(please include international prefix as needed)
Your answer
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