ANNUAL MEMBERSHIP FEE RENEWAL

Surname:

First Name:

DOB

Phone:

Email:

Postal address:

Post code:

May we provide your phone number to other members?

Yes

No

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Class of Memberships

(1) Annual payment

(2) Half yearly payments (June and Dec)

Ordinary: $910/ $465

Weekday: $695 / $355

Lifestyle: $695 / $355

(between 20 and 40 km, driving)

Country: $600 / $315

(>40 km, driving)

Young adult: $320 / $165

(19 to 29 years old)

Junior: $105 / $60

(<19 years old)

Choose class:

Choose payment option:

One annual payment

Two half yearly payments (June & December)

Preferred payment methods:

1. DIRECT DEPOSIT - National Australia Bank, BSB 084852 Acc. No. 258230401 (Please include your name on the transfer.)

2. DEBIT or CREDIT CARD (Visa or Mastercard) pay at the pro shop. A 1.5% card fee applies to Debit or Credit card payments. This will be $11 on a full Membership.

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By signing this form, you confirm your intention to remain a financial member until June 30, 2024. Provisional membership applies until full membership is agreed to by the next management committee meeting.

Please confirm by ticking the box below:

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