NOMINATION FOR MEMBERSHIP
The personal information provided by you in this Nomination for Membership will be used to process your membership application. You are not obliged to complete those details which you do not wish to disclose but this may mean that your nomination is delayed or, possibly, rejected.
The Club must protect the privacy of the information which is collected, stored, used or disclosed. The Club will do this by taking reasonable steps to ensure that the personal information which you give to the Club is protected against any misuse, loss, unauthorised access or disclosure.
As part of the nomination procedure, your nomination form will be placed on the Club’s noticeboard for 14 days unless you advise the Club in writing that you do not wish this to occur. The Club will 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 who provide services under contract to our Club.
Correspondence:
Telephone: (08) 9384 8226
Fax: (08) 9484 9990
Email: admin@claremontyachtclub.org.au
Website: www.claremontyachtclub.org.au
Nomination for Membership
(Please print clearly and tick boxes
provided as appropriate)
Name: Title Surname
Christian Name
Preferred Name
D.O.B.
___________________________________________________________________________________________________________
Home Address: ______________________________________________________________________________________________
Postal Address:______________________________________________________________________________________________
If different
to home address
Membership Class: ¨ Senior 25+ ¨ Senior 21-25 ¨ Senior 18-21 ¨ Senior Student ¨ Junior <15 ¨ Junior 15-18 ¨ Country ¨ Dinghy 18+ ¨ Associate ¨ Parent & Child Sailing Membership
¨ Reciprocal Name of Host Club: ___________________________
Membership No.____________
Membership Category: ¨ Sail ¨ Power ¨ Dinghy
Spouse____________________________________________ Male/Female
DOB:_______________________________________
Home Phone No: ____________________________________ Mobile
Phone:_____________________________________________
Business Phone No.: Fax No.: ______________________________________________
Email: ____________________________________________ Name
of employer:_________________________________________ Position:
Trade or professional
qualifications: If self employed please give details: _________________________________________________
Type of Business: _______________________________________________________________________________
a
Would you like Midstream Newsletter
emailed? Y / N
Would you like Sailing Newsletter emailed Y / N
Would you like Boat Torque
emailed Y / N
CYC Junior Sailing
Foundation
(if you wish to contribute $3.00 to further encourage junior sailing please
tick) Yes ¨
Ron Tough Junior Sailing
Foundation
( if you wish to contribute $2.00 please tick Yes ¨
a
Are you a boat owner? ¨ Yes
or ¨ No ¨ Power
Boat ¨ Sail
Boat ¨ Centre
Board/Dinghy
Boat Type: _________________________________ Radio Call Sign:___________________________________
Previous boating
experience (give details): ___________________________________________________________
What motivated you to join
the Club: ______________________________________________________________
___________________________________________________________________________________________
In case of emergency contact: _______________________________________________________________________
Surname Christian
Name(s) Phone
No.
Nomination Fee
The nomination fee is to be submitted with this nomination
form. If the nomination is not accepted the entrance fee will be refunded.
Please see attached form for payment options.
I intend to be
an active member of the Club according to the Club Constitution and Rules. I
will participate by attending General Meetings of Members, Club
functions/social events, busy bees, and carrying out of Duty Officer
commitments and generally supporting core Club activities such as competitive
and social boating events and or volunteering time to provide services or
serving on committees, and by using fuel facilities, the slip facilities (as
appropriate) and/or consider using the function centre facilities and/or
offering sponsorships/donations.
Volunteer Activity:
In what area are you
prepared to volunteer services to the Club?
·
Professional services such as______________________________________________________________________________________
·
Committees/subcommittees such as__________________________________________________________________________________
·
Assisting in race administration ____________________________________________________________________________
·
Promoting social events, excursions, cruises, etc. such as________________________________________________________________
·
Training junior sailing such as__________________________________________________________________________________
·
General painting, gardening, handyman such as ________________________________________________________________
·
Office duties such as mailouts/filing
____________________________________________________________________________
I declare that all of the
information is true and correct
Date: _________/_________/__________ Signature of Applicant: ___________________________________
To be completed by the Proposer
Only Senior Claremont Yacht
Club Members of at least one year’s standing are eligible to propose and second
nominations
I have known the candidate
for _________ years, and I submit the following further information in support
of his/her nomination.
___________________________________________________________________________________________
Name of Proposer: __________________________
Signature: _________________________ Date: ___/____/___
To be completed by the
Seconder
I have known the candidate for _________ years, and I
submit the following further information in support of his/her nomination.
___________________________________________________________________________________________
Name of Seconder: ________________________
Signature: ___________________________ Date: ___/___/____
Office Use Only
|
Date Received |
|
Committee Approval Date |
|
|
Nomination Fee |
|
Posted to Notice Board |
|
|
Entered on Computer |
|
New Member Mail Out |
|
|
Membership Number |
|
Pen Application |
|
|
Parking Sticker Number |
|
|
|
Payment of Nomination Fee (This must accompany your nomination form)
Cash ¨ Cheque Enclosed ¨
Or
Complete the following
section if you wish to pay by credit card (AMEX & Diners not accepted)
I hereby authorise Claremont
Yacht Club (Inc) to debit my credit account with the sum of $____________
¨ Bankcard ¨ Visa ¨ Mastercard
Card No. ¨¨¨¨ ¨¨¨¨ ¨¨¨¨ ¨¨¨¨
Expiry
Date: _______/______/_______ Cardholders Signature:__________________________________________
Name:______________________________________________________________________________________
Credit Card Standing Authority
For ease of payment
Claremont Yacht Club (Inc) can charge your monthly invoice/statement balance to
a nominated credit card. The amount will be debited to your credit account on
or around the 21st day of the following month. This allows you to
view your club statement prior to the charge to your credit account.
Complete the following section if you wish to pay by
credit card:
I hereby authorise Claremont
Yacht Club (Inc) to debit my credit card account each month, with the total
amount outstanding on my Club Statement Account.
This Authority will commence
on the _______________ and remain in force until cancelled by me.
¨ Bankcard ¨ Visa ¨ Mastercard
Card No. ¨¨¨¨ ¨¨¨¨ ¨¨¨¨ ¨¨¨¨
Expiry
Date: _______/______/_______
Cardholders Signature: _________________________________________
Name:
______________________________________________________________________________________
Schedule of Fees
|
Membership Grades |
Nomination Fee On Application |
Annual Subscription 1st Jul –
30th June |
|
Senior (25+) |
$660.00 |
$880.00 |
|
Senior (21-25) |
$330.00 |
$440.00 |
|
Senior (18-20) |
$165.00 |
$220.00 |
|
Senior
Student
|
$165.00 |
$220.00 |
|
Special (Senior Members 60+ who
have been a financial member for 30+ years) |
N/A |
$220.00 |
|
Country |
$165.00 |
$220.00 |
|
Life |
|
$3.00 |
|
Dinghy (18+) New members only |
Nomination fee waived for 2009
(save $330.00 valid for 2009/2010 season only) |
$440.00 |
|
Junior (-15) New members only |
N/A |
$20.00 |
|
Junior (15-17) New members
only |
N/A |
$20.00 |
|
Parent
& Child Sailing Membership (Spouse receives free social
membership, conditions apply) |
N/A |
$100.00 |
|
Associate (Spouse of Senior) |
N/A |
$143.00 |
|
Social |
N/A |
$55.00 |
|
Crew |
N/A |
$55.00 |
|
Reciprocal
|
N/A |
$70.00 |
REDEEMABLE VOUCHERS
Senior Members $100 is charged every 3 months (July, October, January & April)
Senior Dinghy Members $60 is charged every six months
(July & January)
Social and Crew Members $60 is charged every six
months (July & January)
If
the vouchers are not redeemed within six months, they will be invalid. There will be no exception to this rule.
These vouchers may be used for Friday night meals, bar purchases, Club clothing
and accessories, regalia and burgees. They may not be used to pay membership
fees, pen fees or fuel purchases.
TROPHY COLLECTIONS Senior members
will be debited $11 & Junior members will be
debited $5.50 annually to contribute to trophy costs
NEW
MEMBER’S NIGHT Held regularly and is to be attended by Applicant,
Proposer and Seconder
MEMBERS
will be charged for a Club Book ($30) and Club Burgee ($45)