Request to pay subs to RPC Ltd by Installments
Member Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
example@example.com
I wish to split my Membership subs into instalments
*
Please Select
Two instalments
Monthly
Other
I agree to pay my subs as per my selection above to the Treasurer or Polo Manager, I am liable for the full amount even if I stop playing at the club during the course of the season. Please state below that you agree to the above statement and what date each instalment will be paid by, along with the amount of each instalment
Submit
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