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Membership Application Form

I hereby apply to become an ORDINARY/SOCIAL/JUNIOR member of the Central Coast Aero Club Limited and request you to enter my name in the Register of Members accordingly. I agree to be bound by your Memorandum and Articles of Association and any rules, regulations and by-laws of the Club from time to time in force.

 

Full Name of Applicant
Last Name :
First Name(s) :
Residential Address:
Street :
Suburb :
State : Postcode :
Telephone
 (Please include area code)
BH :
AH : Mob :
EMAIL Address(s)
 
Primary :
Other :
Occupation  
Brief Description :
Name of Employer :
(or) I am self Employed
Employer's Phone :
Age  
21 Years or older :
(or) Date of Birth
Other Memberships ( Please Specify )
Aero Clubs :
Aviation Related :
Has your membership application for any club been deferred or rejected ?
No : Yes :
  If Yes , please state reason(s) in the box below
Membership Type Required
  Ordinary Social Junior
Preferred Contact Method
  Postal Email Phone
Submit Application (please check all details are correct)

BY SUBMITTING THIS FORM I DECLARE THAT THE INFORMATION AND ANSWERS GIVEN IN THIS APPLICATION ARE TRUE AND CORRECT AND I HAVE NOT WITHHELD ANY INFORMATION LIKELY TO AFFECT THE DECISION OF THE COMMITTEE OF THE CLUB AS TO MY ELIGIBILITY FOR MEMBERSHIP.
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