ClubsNSW Membership Application

Club Details

Name Of Applicant (Club)

Street Address

Address

Address 2

City/Town

State/Province

Postal Code

Is postal address Is the same as street address?

Yes

Postal Address

Address

Address 2

City/Town

State/Province

Postal Code

Email Address

Website

Telephone

Fax

No. of Members

No. of Employees

Full Time

Part Time

Casual

Key Contact Information

Position Title

Secretary Manager

Honorary Secretary

General Manager

CEO

Other (Please Specify)

Prefix

First

Middle

Last

Position/Title

Chairman

President

Other (Please Specify)

Contact Name

Prefix

First

Middle

Last

Date Club Formed

No of *EGM

Month Of AGM

Please attach a copy of your most recent Annual Report

Upload requirements

Please attach a copy of your most recent Constitution

Upload requirements

Applicant’s Club Liquor Licence No.

LIQC

Applicant’s ABN

By executing where indicated, the Applicant agrees to be bound by the Registered Rules of The Registered Clubs Association of New South Wales (the Rules) and all By-laws made pursuant to the Rules and accepts the Membership Application Terms & Conditions below.

Executed by a duly authorised representative of the Applicant:

Position/Title

First

Middle

Last

Date

Signature

Sign above

ClubsNSW Membership Subscription Rates

If you have any queries in relation to the amount that will be payable as annual subscription fees, please contact our Finance team on 02 9268 3022.

Yes, I have read, understand and accept the Membership Application Terms & Conditions. I confirm I am authorised to do this for the club and, where relevant, in my own capacity. View the ClubsNSW Privacy Policy and our Collection Notice to understand how we manage and use your personal information.