Membership Application Form If you are human, leave this field blank. Date Surname * Full First Names * ID Number * Passport Number (If applicable) Date of Birth * Residential Address * Postal address ( if Different) Home Tel No: Work Tel No: Mobile Tel No: Email Address Previous Club(s) and H Cap Membership Bowls Female Dual Mem Female Full Female Not Affiliated Female Senior +60 Female U40 Junior Male Dual Mem Male Full Male Life Male Not Affiliated Male Senior +60 Male U40 Social Squash Swallow To be handicapped at ST Yes No I hereby undertake to abide by the Constitution of the Simon’s Town Country Club and understand that the termination of my membership can only occur according to the constitution of the Club. I understand that should my membership be approved it will be subject to a probation period of 12 months. I accept that yearly subscriptions are due by the 31st August yearly, and should I want to resign from the Club, my letter of resignation must reach the Club Secretary / Manager before the 31st August in any given year, or it will be assumed that I wish to continue my membership for the ensuing year, and that I will be liable for subscriptions for the following year. I declare that the information provided overleaf is true and correct in every aspect and understand that my membership will be terminated if this is found to be incorrect. A copy of the Constitution is available to me on request. I hereby agree that I have read and will abide to the conditions as presented above. Signature Image ( (Parents if Applicant is a Minor): Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 3MB Proposer: Seconder: All payments are to be made payable to: Standard Bank, Fish Hoek Branch Code: 03 600 09 Account. No: 072 064358 Submit
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