RSL-SA: NT Application for Membership
RSL Darwin Sub-Branch
Which type of membership are you applying for?
*
Service Membership
Affiliate Membership
What is your reason for joining as an Affiliate Member?
Immediate family member served (immediate includes grandparents)
Currently or previously worked as a defence contractor
Provide services or assistance to RSL
Other
When you apply to or renew a RSL membership, you must prove your identity.The documents use to prove your identity include: Military Identification; or- Enlistment Certificate or Discharge Certificate; or- Service Record or PmKeys Record.
Browse Files
Drag and drop files here
Choose a file
Those documents allow us to: conduct a national criminal history check (if required), conduct a sex offender register check, gather any findings of misconduct by a reporting body, be assured you are who you say you are.
Cancel
of
When you apply to or renew a RSL membership, you must prove your identity. The documents use to prove your identity include: NT Recognised Government Identification Card, Driver’s Licence / Passport / Birth Certificate.
Browse Files
Drag and drop files here
Choose a file
Those documents allow us to: conduct a national criminal history check (if required), conduct a sex offender register check, gather any findings of misconduct by a reporting body, be assured you are who you say you are.
Cancel
of
Personal Details
Title
*
Name
*
First Name
Last Name
Post Nominals (Honours / Awards / Decorations):
(Campaign and service medals can be listed later on form)
Residential Address
*
Street Address
Optional - Street Address Line 2
City
State
Postcode
Postal Address (Only complete this if it is not the same as your residential address)
Address
Optional - Address Line 2
City
State
Postcode
Mobile Phone Number
*
Mobile
Phone Number
Home
Email:
*
example@example.com
Date of Birth:
*
-
Day
-
Month
Year
Sex:
*
Male
Female
Country of Birth:
*
Sex:
*
Back
Next
Service Details
Sub-Brand Membership Form
By agreeing to become a Service Member of the RSL Darwin Sub-branch, you agree to the below:
*
Bound by the RSL National Constitution, By-Laws and any Rules and By-Laws of the State Branch. You agree to uphold and maintain the values of the RSL. You do not have a current violence-related intervention order in place. You are not registered on any State or Territory Sex Offender and / or Child Protection Register. You have not conducted subversive or prejudicial behaviour to the objects and values of the RSL.
Other Details: Is there any other information to be disclosed if not conforming to the above? Please provide details.
Service Number:
PM Keys Number:
Rank:
*
Are you a currently serving member (can be full-time or reservist)?
*
Yes
No
Service
*
Air Force
Army
Navy
Other
Type
*
Regular
Reserve
National Service
Other
Date of Enlistment:
*
-
Day
-
Month
Year
Date
Date of Discharge:
-
Day
-
Month
Year
Date
Discharge Certificate No (if applicable):
Length of Service (Years/Months):
*
Campaign & Service Medals:
Theatres of Operations of Conflicts (select all applicable):
World War 2
Borneo Confrontation
Reserves/CMF
Korea
Peacekeeping
National Service
Malayan Emergency
Somalia
East Timor
Vietnam
Gulf War / Kuwait
Afghanistan
BCOF (Japan)
Regular Forces
Iraq
Other
Back
Next
Affiliate Membership Details
By agreeing to become an Affiliate Member of the RSL Darwin Sub-branch, you agree to the below:
*
Bound by the RSL National Constitution, By-Laws and any Rules and By-Laws of the State Branch. You agree to uphold and maintain the values of the RSL. You do not have a current violence-related intervention order in place. You are not registered on any State or Territory Sex Offender and / or Child Protection Register. You have not conducted subversive or prejudicial behaviour to the objects and values of the RSL and you agree to accept the decision from the RSL Elected Committee regarding your membership application.
Other Details: Is there any other information to be disclosed if not conforming to the above? Please provide details.
Are you related to a Service person?
*
Yes
No
Service Number:
*
Name:
*
Unit Served with:
*
Conflict:
*
Back
Next
Previous Membership Details
If applicable
Previous Membership:
*
Yes
No
Date first joined the League:
*
-
Day
-
Month
Year
Date
Badge number of previous membership:
*
If applicable
State & Sub-Branch of previous membership:
*
If applicable
Back
Next
Declaration and Agreement
*
I declare that the above information is true and correct and I agree to uphold the Constitution of the League and its By-Laws.
Signature
*
Date Signed
*
-
Day
-
Month
Year
Date
Privacy Statement
We will not use any of the information on this membership form without your specific permission in writing, other than to record you as a member of the League and will not pass that information to anyone outside the League. ABN 19 219 796 904
Back
Next
Submit
Should be Empty: