APPLICATION FOR MEMBERSHIP - REELING VETERANS INCORPORATED Memberships are due on 30 June annually. Reeling Veterans committee meet on the second Tuesday of each month and new applications for membership are considered at this meeting. If approved, a membership Keyring and constitution will be forwarded to the member at their postal address.
Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Post code
Date of Birth
CONTACT NUMBER :
*
Email
*
example@example.com
Are you a current / ex Defence member
yes
no
Branch of Service
Army
Navy
Airforce
Police
Fire
Ambulance
Correction
Other
PARTNERS DETAILS
Name
First Name
Last Name
Date of Birth
Email
example@example.com
JUNIORS
Name
First Name
Last Name
Date of Birth
Name
First Name
Last Name
Date of Birth
Name
First Name
Last Name
Date of Birth
Name
First Name
Last Name
Date of Birth
Name
First Name
Last Name
Date of Birth
MEMBERSHIP RULES
PRIVACY STATEMENT: Reeling Veterans Inc is subject to the provisions of the Privacy Act 1988. Personal information provided by you on this application 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 the right to access and correct any of your personal information that Reeling Veterans Inc holds about you.
I/We agree to be bound by the constitution and other rules adopted by ReelingVeterans Inc.
*
Agree
I acknowledge that by ticking this box, I am signing this membership application form for Reeling Veterans Incorporated.
*
Agree
PAYMENT FORM
Memberships Types
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next
( X )
Single Membership (Darwin local)
$
20.00
AUD
Single Membership
$
15.00
AUD
Family Membership (Darwin Local)
$
40.00
AUD
Family Membership
$
30.00
AUD
Pensioner Family
$
20.00
AUD
Single Pensioner
$
10.00
AUD
Total
$
0.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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