Membership Application [ Full $180 – Seasonal $100 – Intermediate $55 – Junior $40 – Social $20 ] Fields marked with an * are required First Name * Last Name * Membership * Full ( March - Feb ) Seasonal ( April - September ) Intermediate ( 17-20 Full Time Student ) Junior ( 16 and under ) Social ( No Golf Included ) Divider Address Details Address Details Address * City * Postcode * Divider Postal Address Details Postal Address Details Postal Address City Postcode Divider Contact Details Contact Details Home Phone (use mobile if you don't have one) * Work Phone Mobile * Email * Email (Alt) Divider Copy Occupation Details Occupation Details Occupation * Employer * Divider Emergency Contact Emergency Contact Contact * Relationship * Spouse Parent / Gaurdian Friend Other Phone / Mobile * Divider Payment Details Payment DetailsPayment must be made on application.Bank DetailsBSB: 033625ACCOUNT: 233729 Payment Method * Direct Credit (EFT) Cheque Cash Divider Nominee's Nominee'sNominee's must be members of the club, however if you do not know any members please leave it blank. Nominee 1 Nominee 2 Divider Declaration DeclarationI ' 'understand that by becoming a member of Parklands Golf Club Incorporated I agree to be bound by the rules of Parklands Golf Club Incorporated for the time being in force. Declaration Acceptance * If you are a human seeing this field, please leave it empty.
