2020/21 Ordinary Membership Application

Application for 2020/21 Ordinary Membership

To obtain voting rights in time for the 2020 AGM, this MUST be completed no later than 12pm Friday 23 October, 2020.
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
What is your interest in the Cockburn Basketball Association and reason for applying for membership?
Type of Membership

New Member Renewal
CBA Constitution - Verified October 2020.
APPLICATION FEE - $22 (GST Inclusive) payable with application. This fee is non-refundable.

PAYMENT BY DIRECT DEBIT - Please send confirmation of payment to address below and label as 'FirstNameLastNameOrdinaryMember'.

Cockburn Basketball Association

BSB 306 086

Acc 4621117

NO MEMBERSHIP APPROVALS WILL BE VERIFIED WITHOUT PAYMENT BEING RECEIVED FIRST.
Ordinary Membership Applicant's Signature

Clear
Nominating Ordinary Member's Signature (an existing Ordinary Member)

Clear
Should be Empty:

Application for 2020/21 Ordinary Membership