Online membership form - Westown Golf Club

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Online Membership Form

Membership Form

First Name*

Last Name*

Gender*

Male Female

Home Phone Number*

Work Phone Number

Fax Number

Mobile Phone Number

Address Line 1*

Address Line 2*

City*

Post Code*

Email Address*

Date of Birth

Are you currently a member or have you ever been a member of a Golf NZ affiliated golf club? Yes

Membership Number

Occupation*

Introduced By (Member):

Are you a New Zealand Citizen?*

Yes No

Membership Type Requested*

Emergency Contact Name

Emergency Contact Number

Privacy Statement: The information collected in this form will be held in accordance of the Privacy Act 0f 2020. In terms of this nomination, I the applicant will hereby abide by the rules of the Golf Club and give my consent to the Westown Golf Club to store and hold my personal details. It is understood by the Club that my personal details are confidential and the use of such is restricted for the use by the Club, New Zealand Golf and/or in the event of a request from the New Zealand Police.

Please tick:

	Address: 964 Mangorei Road RD 1 New Plymouth 4371
	Phone: (06) 758 6933
	Email: admin@westowngolfclub.co.nz

Membership Form

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