JOINING FORM

JOINING FORM

Whangarei Rock & Gemstone Club Inc


Postal Address: C/o Shirley Gates, 787 State Highway 14, RD 9, Whangarei 0179 or email to sgates@actrix.co.nz.

Application to Join the Club


Please print this page, complete all sections of this form, sign it, and either post or email it to S. Gates as above.

For the family rate, please complete the names for each person and all people in the family. 18 years or older are to sign.

Once the subscription has been paid you will be added to our membership list, and will receive newsletters and other club information. Subscriptions may be paid in cash at a club meeting or open day, or preferably via internet banking.

When paying by Internet banking please provide our treasurer with details so that she can issue a receipt. Her email address is Jacqueline.fowke@gmail.com.

Our bank account number is 03 0498 0828840 000 Westpac Access

Annual Subscriptions

Subscriptions are due for renewal on May 31 each year.
Junior $5 (16 or younger, or school students)
Associate $16
Single $25
Family $35 (husband, wife, and children who are at school)

Name(s):
Postal Address:
Phone:
Email (if applicable):

Newsletters will be sent by Email.

I/we apply to join the Whangarei Rock & Gemstone Club Inc, and agree to abide by the Constitution and Rules of the Club. I/we hereby agree that my/our membership, if accepted, will only be valid and current by having paid in full the current annual subscription fee.

Signature(s):

Date: 

Office Use Only
Membership accepted by (Date) : ___________________________________
Details passed to Treasurer (Date):__________________________________
Details passed to Newsletter Editor (Date): ___________________________