Application Form - Naval, Military and Air Force Club of South Australia

NAVAL MILITARY & AIR FORCE CLUB
OF
SOUTH AUSTRALIA INC.
APPLICATION FOR MEMBERSHIP
CANDIDATE’S PERSONAL DETAILS:
Title/Rank........................................First Name(s)...........................................................................................................
Surname..........................................................................................Date of Birth.............................................................
Decorations/Post Nominals...............................................................................................................................................
Residential Address.........................................................................Suburb/City..............................................................
State/Postcode..................................................................................Country....................................................................
Postal Address (if different)..............................................................................................................................................
...........................................................................................................................................................................................
Phone (business hours)........................................(after hours).......................................(mobile).....................................
Email.................................................................................................................................................................................
Occupation.....................................................................................Employer...................................................................
Membership of Other Clubs, Societies or Professional Associations...............................................................................
...........................................................................................................................................................................................
All Officers (Serving or Non-Serving): Date of Commission or Appointment................................................................
Are you currently serving in the Regular or active Reserve Branches of the ADF or in the SAPOL? Yes / No.............
Details...............................................................................................................................................................................

2
MEMBERSHIP CATEGORY (PLEASE TICK ONE ONLY)
CATEGORY CLASS TICK
Ordinary
Town – Non-Serving Resident of Adelaide Metropolitan Area
Country – Non-Serving Resident of Country South Australia
Serving- Active Regular or Reserve Officer (ADF or SAPOL) over 30
Serving- Active Regular or Reserve Officer (ADF or SAPOL) under 30
Associate
Spouse or Widow of an Ordinary Member
Under 40 yrs Son or Daughter of Ordinary Member
Under 30 years of Age – Not Serving
Active Regular or Reserve Officer Posted to SA for up to 4 years
Absentee – Interstate Resident Non-serving
Absentee – Overseas Resident Non-serving
Absentee – Serving Officer Resident Interstate or Overseas
Reciprocal Associate (name of club):
Business
Category A (from 1 to 4 members)
Category B (from 5 to 7 members)
DECLARATION
I, the abovenamed candidate, hereby declare that the foregoing information is true and correct in every particular
and hereby agree, if elected, to be bound by the Constitution & By-Laws of the Club.
Signature.................................................................. Date...........................................................................
PROPOSER
I have known the candidate for.................years and
hereby nominate the candidate for election to
membership of the Club.
Name......................................................................
Relationship with the Candidate..................................
Signature..................................................................
Date...........................................................................
SECONDER
I have known the candidate for.................years and
hereby nominate the candidate for election to
membership of the Club.
Name........................................................................
Relationship with the Candidate..................................
Signature..................................................................
Date...........................................................................
Applicants without Proposers please include the names of two referees below:
REFEREES
Names................................................................................... ......................................................................................
Relationship with the Candidate......................................... ......................................................................................
Contact phone numbers....................................................... ......................................................................................