Membership Application Form

For further information or clarification on joining the Launceston Golf Club as a member please complete the Enquiry Form below and we will contact you as soon as is possible.

Your Details:

Class of Membership:Title:
First Name: Known as:
Surname:Middle Initial:

Home Address:
Suburb:Post Code:

Postal Address:
Suburb:Post Code:

Phone (H):Phone (W):
Fax:Phone (M):
Your Email:Occupation:
Left/Right Handed:LeftRightDate of Birth:

Have you been a member of an affiliated golf club in the last five years:YesNo
If so name of club:
Previous Golflink No.:Previous Handicap:
Will we be your
home club?:YesNo

Have you been refused membership of an affiliated club (or other sporting club) or has your membership of an affiliated club been terminated (other than by resignation) within the previous five years and, if so, particulars:

Have you been convicted of any offence with respect to which you have been sentenced to a term of imprisonment exceeding 3 months (whether or not wholly or partly suspended) within the last five years and, if so, particulars:

Please attach hereto two written references or two referees with
appropriate contact details:

Proposer’s Name:
Preferred Phone No.:Email Address:
Written Reference:

Seconder’s Name:
Preferred Phone No.:Email Address:
Written Reference:

Emergency Family Contact Information:

Name
(First and Surname):Relationship
(i.e. Wife, Son, Friend):
Phone Number
(emergency contact):

Validation

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Membership Application Form

Your Details:

Please attach hereto two written references or two referees with appropriate contact details:

Emergency Family Contact Information:

Membership

Please attach hereto two written references or two referees with
appropriate contact details: