2023/2024 - Ordinary Membership Application

2023/2024 Ordinary Membership

Form must be completed to be a voting member of the association in 2023/24 - with expiry at the 2024 AGM. Ordinary membership is required to vote at the 2024 AGM, and for board nominations.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / 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 MemberRenewal
CBA Constitution - Verified at AGM in November 2022.
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 ** NEW ACCOUNT DETAILS BELOW **

BSB 066 107

Acc 10827465

NO MEMBERSHIP APPROVALS WILL BE VERIFIED WITHOUT PAYMENT BEING RECEIVED FIRST. ALL MEMBERSHIPS REQUIRE BOARD APPROVAL, OF WHICH APPLICANTS WILL BE ADVISED OF THEIR STATUS FOLLOWING THE NEXT CBA BOARD MEETING.

As per the CBA constitution, CBA applications require endorsement from an existing ordinary member. An email declaration from an existing ordinary member is required to be sent to tyrone@cougarfamily.com following your application.
Ordinary Membership Applicant's Signature*

Clear
Should be Empty:

2023/2024 Ordinary Membership