Bathurst RSL Club Membership Application

Bathurst RSL Club Membership Application

Simply complete the membership application form below to become a member of the Bathurst RSL Club. Your membership will be processed within 2 working days and you can start enjoying the benefits of being a Bathurst RSL Club member. You just need to visit our club with a valid form of identification so we can verify your membership, take a photo of you and issue you with your membership card. Our membership runs from the 1st of January until the 31st of December. Discounted rates are applicable for Pensioners/Seniors and Sub-branch members. If this is applicable to you, please come into the Club to become a member. For more information, contact Reception on 02 63332999.
Title*
Name*

First NameLast Name
Preferred Name
Date of Birth*

DayMonthYear
Phone Number*
Email Address*
Residential Address*

Street Address

Street Address Line 2

CityState/Territory

Postal Code
Postal Address (if different from Residential Address)

Street Address

Street Address Line 2

CityState/Territory

Postal Code
Occupation*
Save a tree & go digital! I wish to receive my Renewal Notice & Notice of AGM via email.*

YesNo
I consent to receiving promotional material which may contain information on Gaming Machine promotions.*

YesNo
Do you wish to receive a concise copy of the Annual Financial Report?*

NoYes by EmailYes by Hard Copy
I declare that I am over the age of 18 years and agree to abide by the Club's Constitution and By-Laws (a copy is available at Front Reception). I understand that provisional Membership is granted pending full election to Membership at the following monthly Board Meeting. Any Member not elected to Full Membership by the Board will be advised in writing with a full refund of Membership subscription.*

Yes

Membership Options

1 Year Ordinary Associate$11.00AUD

3 Year Ordinary Associate$22.00AUD

Total $0.00AUD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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