MAROUBRA SEALS
Sports & Community Club Ltd
212-220 Marine Parade
MAROUBRA BEACH
P.O.Box 340 MAROUBRA 2035
Tel.No.9349-2299 Fax.No.9349-5658


NOMINATION FOR MEMBERSHIP
  • NOMINATION FOR MEMBERSHIP
    1st JANUARY – 31st DECEMBER
  • Ordinary Membership - All persons who have attained 18 years of age or over. Annual Subscription $11.00 (includes GST)
  • Senior (Ord.) Membership - All persons who have attained 60 years of age or over. Annual Subscription $5.50 (includes GST)
  • There is no joining fee.
  • Payment must accompany Nomination Form
  • 5 and 10 year memberships available
PREFERRED FORM OF ADDRESS
(ie. DR. MR. MRS. MISS. MS)
FIRST GIVEN NAMES
FAMILY NAME (i.e. SMITH)
I wish to join as an : ORDINARY MEMBER or
SENIOR (ordinary) MEMBER
ADDRESS
POSTCODE
PHONE NO
BUS. PHONE NO
EMAIL ADDRESS
AGE
DATE OF BIRTH
OCCUPATION
SPECIAL NOTE
If Nominee is under 21 years of age, PROOF OF AGE must be produced when subscription is paid

Details of "Proof of Age" furnished:


I hereby apply for election as a member of Maroubra Seals Sports & Community Club Limited. I declare that I have attained the age of 18 years, and stated date of birth is correct. When elected, I agree to abide and be bound by the Articles and Rules of the Club.
SIGNATURE
(Of Candidate)		 __________________ DATE __________________



OFFICE USE ONLY

Receipt No
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Date Paid
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Amount Paid
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Staff Sig
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Card No
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Date Joined
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