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: ………………………………………….