Membership nomination form
We the undersigned members of Eastern Suburbs Rugby Union Football Club Inc. hereby nominate:
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
for membership of the Association in accordance with Rule 11.A (i) of the Constitution.
*
senior player membership
social membership
Nominator 1 Name
*
First Name
Last Name
Nominator 1 Signature
*
Nominator 2 Name
*
First Name
Last Name
Nominator 2 Signature
*
I accept my nomination for membership and agree to comply with the Constitution and policies of the Association.
*
Date
*
/
Day
/
Month
Year
Date
Click here to read the Constitution and policies.
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Senior player/social membership
$
30.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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