MEMBERSHIP APPLICATION FORM

XxXxxxxx Park Nerang Mens Bowls Club

MEMBERSHIP APPLICATION FORM

Surname: …………………………………………Given Names: .………………………………………...

Address: …………………………………………………………..Suburb:……………….P/Code:………

Occupation: ……………………..………………………………Date of Birth: …..…/………./……....

Email: …………………………………………………..……………….Mobile: ……………………………….

PLEASE NOTE: Upon becoming a Member of the XxXxxxxx Park Nerang Men’s Bowls Club, you automatically become a financial Member of the Nerang Community Bowls Club

Membership No: …………..

Bowling Declaration:

1. Have you ever been, or are you under suspension, been expelled or refused admission or membership with any other Club? YES/NO (Circle one). If yes, please provide details.

2. Have you played bowls before YES/NO

If you circled NO, you will need to be approved to play by one of our accredited Club Coaches.

3. If you are/were an affiliated bowler, Name of Club: ………………………………………….

(You will need to attach a clearance if your answer was YES)

4. Please supply your bowling history:

Pennant: ………………………………………………………………….…………

Championships: ……………………………………………………………………

Committee Positions: ………………………………………………………………

5. Are you an accredited National Umpire YES/NO If YES, Reg No: …………

Are you an accredited National Coach YES/NO If YES, Reg No: …………

In signing this application, please note you are providing the Club with your approval to provide any or all of the above information to other Club, District, State and National Bowls Bodies.

Applicants Signature: …………………………………………… Date: ………………………

Proposed by: (Print Name): …………………… Signature: ……………. Memb No: …………...

Seconded by (Print Name): …………………… Signature: …………….. Memb No: …………...

Receipt No:…………Date……………….Amount…………………..Signed……………………………….