APPLICATION FOR MEMBERSHIP - Amazon S3



APPLICATION FOR MEMBERSHIP

(Please use BLOCK LETTERS)

|Last Name: |Given Names: |

|Address: |

| |Postcode: |

|Telephone Nos.: (H) |(W) |(Mob.) |

|E-mail: |

|(PRINT CLEARLY) |

|DATE OF BIRTH: |Educational Institution: |

|To be completed by all members | |

|I wish to apply for membership of the DENDY PARK TENNIS CLUB INCORPORATED and, in the event of my admission, I agree to be bound by the rules of|

|the Club from the time of being in force |

MEMBERSHIP CATEGORIES (Fees include 10% GST component). The following fees apply for membership valid until 31st August 2017

|CATEGORY |MEMBERSHIP FEES |Joining Fee |TOTAL-FEE PAYABLE |

|Playing |$335 |Nil |$335 |

|Family |$525 |Nil |$525 |

|Student |$235 |Nil |$235 |

|Junior |$180 |Nil |$180 |

PRIVACY STATEMENT:

Dendy Park Tennis Club is required to forward the above information to Tennis Victoria, registering players and covering members with Personal Accident Insurance (PAI).

I agree the above information be forwarded to Tennis Victoria.

…………………………………………… ……………………………..…..

Applicant’s Authority Date

Print name of signatory if not applicant (i.e. parent or guardian of junior applicant):

Credit Card Payment – Please tick

MASTERCARD VISA Amount Paid: $………………

CARDHOLDER NAME::……………………………………………………………………..……………...

Card No.

.

Signature:............................................................................................... Exp date: /

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