APPLICATION FOR MEMBERSHIP

Post with fees to ACTRVGA PO Box 928, Gungahlin ACT 2912

Membership enquiries: Please contact the Secretary by email at davmem99@gmail.com or phone 0417 458 094

 

Name:    ……………………………………….………………….….…

 

Address:          ……………………………………….……………………..…

 ……………………………………………………………………. 

Post Code: ………………..

 

Email:      …………………………………………….…………………

 

Phone:      Home or Mobile:    …………………….…………

 

Home Club: …………………………….……. Handicap: ………..….

 

Golf Link Number: …………………………

 

Date of Birth: ……………………………….

 

Membership Fees (valid to 30/06/2019) enclosed: …………………                       

(Nomination $20, Yearly $20)    

or Pay by EFT: BSB: 325185  A/C: 03404444 - Alliance A/C Vet Golf ; Bankname: Beyondbank

Please include your surname and initials in Reference

 

Signature: …………………………………………..…….

Date: ………………………………………….