Kapiti Radio Yacht Club Membership Application

Kapiti Radio Yacht Club

Membership Application
Name*

First NameLast Name
Address*

Address Line1

Address Line 2

Town/CityState / Province

Postal / Zip Code
Phone Number 1

Area CodePhone Number
Phone Number 2

Area CodePhone Number
Email
example@example.com
Ordinary member subscription includes a $10 annual subscription to NZRYA. This does not have to be paid if you are a current member of NZRYA.
I apply for the following membership*
prevnext( X )
Ordinary Member (incl NZRYA subscription)Includes $10.00 NZRYA membership fee
$40.00NZD



Ordinary Member (excl NZRYA subscription)No NZRYA fee. I am already a member of NZRYA
$30.00NZD



Social Member
$15.00NZD



Junior Member
$10.00NZD



Total

$0.00NZD
I am a member of NZRYA through:
Pay your subscription to the account of Kapiti Radio Yacht Club at ASB, Paraparaumu, Account: 12-3157-0167988-00.

Please include your name on the lodgement.
I agree to abide by the Constitution and Regulations of the Kapiti Radio Yacht Club.
Should be Empty: