Mr./ Mrs./Miss./Ms./Dr. (Surname)................................................................. (Please use block letters)
(Christian Names).............................................................................................
Date Of Birth:.....................................................................................................
Postal Address:..................................................................................................
Street Address if different to above:....................................................................
Town:............................................................................ State:...........................
Post Code:.........................................................................................................
Phone (H):................................................ (W)..................................................
(Mobile):...........................................................................................................
E-Mail Address:.................................................................................................
I the undersigned, agree:-
- If elected to abide by the directions of the Secretary/Manager concerning any incident on Club premises in which I am involved;
- I may only be admitted as a member by election of the Committee at a meeting that is held monthly.
- The decision of the Committee in relation to my application is final and no correspondence will be entered into.
- The issue of a membership card to me is only provisional until I have been elected to membership and does not itself admit me as a member.
- Should my application be declined, the fee paid will be refunded and the membership card cancelled.
- Memberships are non-transferable, I, as the Member whose name appears on the Membership card am the only person who may use the card to gain access to or to participate in promotions throughout the Alice Springs Memorial Club.
- The Memorial Club issues the first Membership card to you as part of your joining fee. The actual card costs $15 to supply, so loss of your card or failure to keep it when renewing the following year will result in an additional $15 fee being inccured on top of your renewal charge.
Sign:............................................................... Date:.......................................
I hereby apply for Membership of the Alice Springs Memorial Club and render my Membership fee of $....................
Full: $30.00 Associate: $25.00 Country: $15.00 Aged: $5.00
We, the undersigned, duly propose and nominate the applicant under section 22A of the Club’s constitution.
*Proposer & Seconder must both have been financial members of the club for a period of not less than one year, and must have known the applicant personally for at least six months
Proposer Card No.................... Name................................................................
Signature...........................................................
Seconder Card No.................... Name................................................................
Signature...........................................................
PRIVACY STATEMENT
The Alice Springs Memorial Club Incorporated is subject to the provisions of the Privacy Act 1988. The personal information provided by you on this form will be used to process your Membership Application. Failure to provide all of the requested information may result in your application being rejected. You have a right to access and correct any of your personal information that the Club holds about you.
The Club does not usually disclose your personal information to any other organization or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure.
Your personal information, including information about you obtained as a result of you placing your membership card in a gaming or other Club machine (excluding ATM’s) may be used by the Club for marketing purposes to improve our services and to provide you with the latest information about those services and any new related services and gaming promotions. Do you wish to receive marketing material and information about gaming and other promotions and services?
No Yes