Associate Member Application

Associate Member Application

2025-26
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Postcode
Phone number
Email address
Date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Age
Please tell us a little about yourself.
Please tell us why you would like to join Bondi Surf Life Saving Club
All new members are required to hold a current Working With Children Check (WWCC), please provide your WWCC details below.
Working with Children Check Reference number

Nomination by two current Bondi SBLSC Members

Please provide contact details and written references from two nominators
Nominator 1
Name

First NameLast Name
Email
example@example.com
Mobile number
Please enter a valid phone number.Format: (0000) 000-000.
Written reference from Nominator 1

Cancelof
Nominator 2
Name

First NameLast Name
Email
example@example.com
Mobile number
Please enter a valid phone number.Format: (0000) 000-000.
Written reference from Nominator 2

Cancelof
Do you have any comments or additional information to support your application?
Acknowledgement

I have understand the benefits and obligations of Associate Membership of Bondi SBLSC, I agree to adhere to these and to pay membership fees as notified by the Club.
Signature
Should be Empty: