AUSTRALASIAN GOLF CLUB Inc.

(Affiliated with V.G.L. and G.V)

       APPLICATION FOR MEMBERSHIP

  I  (Mr./Ms)……………………………………………………………..

(Full Name)

Of…………………………………………………………………….

                              (Address)

Suburb…………….………………………. Postcode………………

Occupation……………………………….. Telephone……………….

Date of Birth:……..…………………………(if under 18 years of age)

 I am/was a Member of any other Club?          YES/NO

 Name of Club………………......…  Handicap……….. Golf Link No……………………

Have you ever been refused Membership, or been suspended or expelled from another club YES/NO

In the event of my admission as a Club Member, I agree to be bound by the Rules of the Association for the Time being in force.

……………………………………(Please sign here)         Date………………………..

I……………………………………………

 …………………………….............(Signature of Proposer)      Date………………………..

I…………………………........................... 

......................................................... (Signature of Seconder)     Date.....................................

____________________________________________________________________________

Office use only

Accepted/Declined …………………………….

Date …………………………………..

Fees Paid  $ ………………………..