Membership Renewal Form 2022

Membership Number*

Preferred Honorific:*

Miss

Mrs

Given Names:*

Surname:*

Address:*

Post Code:*

Postal Address:*

Phone:*

E-Mail:*

Mobile:*

Date Of Birth:*

MEMBERSHIP TYPES

ORDINARY - A Financial or Life member of the Forbes Sub Branch of the Returned and Services League of Australia
ASSOCIATE - Member who is 18 years and over, and not a Financial or Life Member of the Forbes Sub Branch of the Returned and Services League of Australia.

MEMBERSHIP OPTIONS (GST incl.)

Membership Type:*

Ordinary

Associate

Ordinary Membership Options:*

1 year ($11)

3 years ($22)

5 years ($27.50)

Associate Membership Options:*

1 year ($11)

3 years ($22)

5 years ($27.50)

STATEMENT RENEWAL TO APPLICATION

I hereby acknowledge that I am over the age of 18 years and agree to conduct myself in a manner fitting the Club Forbes. I lodge a nomination fee and a subscription fee pending my application being accepted.

Date*

PRIVACY STATEMENT

Club Forbes is subject to the provisions of the Privacy Act 1988. The personal information provided by you on this application and attached documents will be used to process your membership application. Failure to provide all of the requested information may result in your application being rejected. You have the right to access and correct any of your personal information that the Club holds about you. The Club does not usually disclose your personal information to any other organisation or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure.

Total

Credit Card

Card Details

Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.