MSQ Affiliation Form 2023

To be eligible to affiliate with Masters Swimming Queensland (MSQ) for 2023, the following requirements must be met:
1. Your club must be an incorporated association
2. Your club must have an ABN
3. Your club's Swim Central Club Details / Finances has been set up with ID verification complete
4. Your club must have a minimum of 7 registered members if a stand alone club; or a minimum of 3 registered members if a 'One Club' (proof of One Club status must be provided)
Please confirm the following:

Club is incorporatedClub has an ABNSwim Central set up is completeClub meets member number requirements
Club Name*
Club Code*
Region*
Is your club a One Club? (part of a Swimming Qld club)*

YesNo
If Yes, Name of Swimming Qld club you are part of:
Club Postal Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Club Contact Information
First Name*
Last Name*
Club Contact Email*
example@example.com
Confirm Club Contact Email*
example@example.com
Club Contact Phone*
Additional 1-3 club contacts to receive MSQ emails:
Please list name and email address
Primary Pool Details
Pool Venue Name*
Pool Venue Location Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Club Committee Members
President Name*
President Email*
example@example.com
President Phone*
Registrar Name*
Registrar Email*
example@example.com
Registrar Phone*
Secretary Name*
Secretary Email*
Secretary Phone*
Race Secretary/Club Captain Name*
Race Secretary/Club Captain Email*
example@example.com
Head Club Coach Name
Head Club Coach Email
example@example.com
Affiliation Details
Please enter the current number of members in your club*
Select applicable affiliation fee:*
AFFILIATION FEES ARE DUE BY 20 DECEMBER 2022.

PLEASE NOTE: Clubs will be sent an invoice, which must be paid by the due date. Do not pay the fee until your club has received the invoice.

A late payment fee of $20 will apply if paid after the due date.
Should be Empty:

Primary Club Contact Information

Primary Pool Details

Club Committee Members

Affiliation Details