MEMBERHSIP APPLICATION FORM

It’s easy to join here at Cessnock Ex-Services Club. With the option to hold a one, two or three year membership that won’t break the budget, why not join and reap the benefits at Cessnock Ex-Services Club.

Pensioners

Full Membership

Nomination Fee:	$2.00	3 yr	$11.60
Annual Subscription:	$4.00	2 yr	$ 8.40
Total:	$6.00	1 yr

Nomination Fee:	$2.00	3 yr:	$17.60
Annual Subscription:	$6.50	2 yr:	$12.40
Total:	$8.50

Member Details

Title
First Name
Surname
Date of Birth:	dd/mm/yy
Home Phone:
Mobile Phone:
Occupation:
Residential Address:	Postcode:
Mailing Address: ( If different to above)	Postcode:
Identification Type:
ID No:

Do You wish to receive Birthday Letters and Members information?
Do you wish to receive a copy of the Annual Report of the Club?

PRIVACY STATEMENT

The Cessnock Ex-Services Club is subject to the provisions of the Privacy Act 1988. The personal information provided by you on this form / application and attached documents will be used to process your membership application. Failure to provide all of the requested information may result in your application being rejected. You have the right to access and correct any of your personal information that the Club holds about you.

The Club does not usually disclose your personal information to any other organisation or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure.
Your personal information, including information about you obtained as a result of you placing your information card in a gaming or other Club machine (not ATM's), may be used by the Club for marketing purposes to improve our services and to provide you with the latest information about those services and any new related services and promotions.

The Club currently sends members correspondence in the Month of their Birthday which offers complimentary vouchers to be used within our club. This is classed as Marketing material.

Signature of Applicant

	I desire to become a member of the Cessnock Ex-Services Club and request you to enter my name on the register of members accordingly and agree to the rules or by-laws made thereunder. I have read the Privacy Statement.
	Please type your name into the box below. Please note: this is your signature to agree to the above.