Albury Club Nomination Form with Statement of Reference (PDF)




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APPLICATION
To The Secretary / Manager

The Albury Club Limited
ABN 74 000 951 879
NOMINATION FOR MEMBERSHIP
To The Secretary / Manager

Date:

WE WISH TO NOMINATE AS A MEMBER OF THE ALBURY CLUB LIMITED:
Surname: *
Given Names: *

Title: *

Date of Birth: *

Occupation: *

Phone: *

Email: *

Address: *
City: *

State: *

Postcode: *

* required fields
Proposed By:

Signature:

Seconded By:

Signature:

N.B.

THIS FORM MUST BE COMPLETED WITH A STATEMENT OF REFERENCE
SIGNED BELOW.

Ballot Committee:

Chairman Signature:

Statement of Reference
I ______________________________________provide reference that _________________________________________ is
of good character and reputation. This nominee will fit the ideals and philosophies of
The Albury Club.
Signature: ___________________________________________________

519 Kiewa Street, Albury NSW 2640
P.O. Box 99, Albury NSW 2640
Telephone (02) 6021 2511
Facsimile (02) 6021 0170
Email: manager@alburyclub.com.au
Website: www.alburyclub.com.au

Office Use:

Application Received:
Date Approved:

Posted to Notice Board:
Applicant Invited:






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