MEMBERSHIP NOMINATION FORM

Phone

This field is for validation purposes and should be left unchanged.

Name(Required)

Prefix First Last

Date of Birth(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Proof of Identity(Required)

Please upload a Driver’s Licence or Passport.

Max. file size: 6 MB.

Spouse's Full Name (if appropriate)

Prefix First Last

Names and relationship of relatives who are/were Members of the Club:

Relative Name 1

Full Name Relationship

Relative Name 2

Full Name Relationship

Relative Name 3

Full Name Relationship

Emergency Contact Name/Next of Kin(Required)

Phone(Required)

Occupation / Qualification

Name of Organisation

Community Interests and Positions held (Current and past):

Membership of other Golf Clubs (Current and past):

Are you a current member or have you previously been a member of the PGA or LPGA? If Yes, please provide details.

Membership of other Social/Sporting Clubs (Current and past).

Have you ever been declined membership, rejected by or expelled from any Club (golfing or otherwise)? If yes, please supply details.

How long have you played golf?(Required)

How often do you play golf currently?(Required)

Where do you play golf most frequently?(Required)

Current Australian Handicap and Golflink number

If no current handicap, golf ability?

If beginner, what steps are you taking to improve your golf?

Other comments to support your application

Membership Nomination Form