Waipawa Golf Club Membership Nomination Form

Surname ______________________       Mr/ Mrs / Miss / Ms

First  Name__________________________________

Date of Birth ______________________     Gender  Male      Female

Postal Address __________________________________________________________

 _________________________________________________Postcode___________

Phone number    __________________________

Email Address  _____________________________________________________

Previous Club ID (if any)   ______________________

Membership Status applied for: Please circle

Full Playing Member                                                                                    Restricted Member                         Summer

Full Playing Member: Under 35 years old                                               9 Hole Member  

 Joint/Family Membership                                                                         Country Member     

 Restricted Member                                                                                     Out of Zone 

 Primary School Student                                                                            College Student 

 Casual Member                                                                                            Social Member 

I hereby consent for the above nomination and agree by all the Rules and Policies of the Waipawa Golf Club.

This application will be placed on the Club Noticeboard until considered by the Club Committee. 

Signature of Applicant __________________________  Date _______________

Email the form to: [email protected]  or

Drop in the letterbox at the Golf Course.

Bank Account. 38 9022 0840247 00