Application for Membership Nomination – Junior

I wish to nominate for membership of The BHGC:*
(Full name in capital letters)
Preferred Name*
Name known as
Category of Membership sought:*
Golf Handicap:*
(if applicable)
A) Details of Nominee
Name*
Prefix First Last
Date of Birth*
DD slash MM slash YYYY
Principal Place of Residence*
Street Address Address Line 2 City State Post Code Country
Home Phone*
Mobile*
Email*
Local Address
Street Address Address Line 2 City State Post Code Country
Local Phone
B) Current School
Current School:*
School Year:*
Address*
Street Address Address Line 2 City State Post Code Country
Phone*
C) Family Members
Family Members of THE BARWON HEADS GOLF CLUB (spouse, parent, sibling)
Name*
Relationship*
D) Other Memberships
Membership of Other Clubs or Voluntary Organisations:
Club / Organisation*
Duration of Membership*
Has the candidate ever been suspended, expelled or denied membership of any golf club, other sporting club or social club?*
- YES
- NO
E) Details of Sponsors
Proposer & Seconder to have been a member for at least 5 years.
SPONSORS
INITIALS & NAME
YEAR ELECTED TO BHGC
YEARS KNOWN TO CANDIDATE
Proposer
*
*
*
Seconder
*
*
*
Date*
DD slash MM slash YYYY
User Receipt Email
Enter your email here to receive a copy of the submission*
OFFICE USE ONLY
Date
DD slash MM slash YYYY
Code
Name
First Last

A) Details of Nominee