Print Application form here - Royal Automobile Club of Australia

ROYAL AUTOMOBILE
CLUB OF AUSTRALIA
ROYAL AUTOMOBILE CLUB OF AUSTRALIA
incorporating Imperial Service Club Limited
DIRECT: 02 8273 2318 ■ FAX: 02 8273 2388 ■ lisa@raca.com.au ■ www.raca.com.au
89 Macquarie Street, Sydney NSW 2000 Australia ■ PO Box R1903 Royal Exchange, Sydney NSW 2000
MEMBERSHIP applicants without proposer/seconder
NAME OF CANDIDATE:_ __________________________________________________________________________________________________
Telephone Bus:________________________ A/H_ ___________________________ Mobile:___________________________________________
Profession:_ ______________________________________________________________________________________________________________
Employer:________________________________________________________________________________________________________________
Position: _______________________________________________________Tenure:_ __________________________________________________
Previous Employer:________________________________________________________________________________________________________
Position: _______________________________________________________Tenure:_ __________________________________________________
Professional Referees (2)
Name :_ _____________________________________________________
Company:___________________________________________________
Position:_____________________________________________________
Telephone:___________________________________________________
Mobile:______________________________________________________
Notes: (Office use only)________________________________________
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Name:____________________________________________________
Company:_________________________________________________
Position:__________________________________________________
Telephone:________________________________________________
Mobile:___________________________________________________
Notes: (Office use only)______________________________________
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Please briefly explain why you wish to join the Royal Automobile Club of Australia:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
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I confirm that the above details are true and correct and, upon membership being conferred, I shall endeavour to maintain and uphold the
Club’s By-Laws required under the terms of membership.
Signed:________________________________________________________Date:____________________________________________________
CEO Referees
1. Y N Date:_____________________________________Outcome: ________________________________________________
2. Y N Date:_____________________________________Outcome: ________________________________________________
Membership Recommendation Y N Date:_ ___________
Date Submitted to Board:___________________________________________________________________________________________________