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