Membership Application

Club Bylaws

Membership Application

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Have you read and accept the Club Rules and Bylaws? *

Click here to see the Bylaws
Bylaws

If no, please provide the principal reason *

Do you wish us to contact you in this regard? *

Salutation - (eg. Dr. Mr. Mrs. or Miss) *

Your profession/occupation: *

Your surname as on your ID document *

Your first or name/s as on your ID document *

Chosen name or nickname - what you like to be called *

Address with proof thereof *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Repeat e-mail address for verification. *

From the e-mail address above, e-mail a copy of your Identity Document, Proof of Residence and a full length photograph of yourself and others included in your membership for our membership directory.

Phone Number *

List at least two current members who would recommend you. (If you do not know any, say None)

Member #1 *

Member #2 *

If you don't know any members yet, please provide at least two other references, your relationship to them and their contact details:

Reference #1 *

Reference #2 *

List at least two others who you believe would make great members and their contact details:

Recommendation #1 *

Recommedation #2 *

Of which other clubs or organizations are you a member? Details and contact information.

Club or Organization #1 *

Club or Organization #2 *

Have you ever been charged with or convicted of a crime? If yes, provide details below. *

Details *

I agree to receiving marketing and promotional materials *

Submit