BANDITS ASSOCIATE
MEMBERSHIP APPLICATION
Please PRINT CLEARLY and ensure that all
details are filled out correctly
(Please Select)
Mr
Mrs
Miss
Ms
(Please Select)
Surname
Surname
Given Name/s
Given Name/s
Date of Birth
Date of Birth
Mr
Mrs
Miss
Ms
Address
Suburb
State Select State
Email
Postcode
Email
(Home)
(Mobile)
(Home)
(Mobile)
Please TICK appropriate box ()
1 year Single
$5
5 years Single
$20
1 year Pensioner/Single
$2
5 years Pensioner/Single
$7
1 year Family
$8
5 years Family
$30
1 year Interstate
$2
Lost Card Fee
$2
Proposed by
Seconded by
Badge No.
Badge No.
I hereby apply for Associate Membership to the Bandits Baseball Club Inc., and for membership of the Belconnen Magpies
Sports Club Inc.
I certify that I am over eighteen (18) years of age. If accepted as a member of Belconnen Magpies Sports Club Inc., I agree to
be bound by the Constitution and By-Laws of the Club. If accepted as a member of the Bandits Baseball Club Inc., I agree to
be
The Magpies Sports Club is subject to the provisions of the Privacy Act 1988. The personal information provided by you on
this form will be used to process your Membership Application and you have the right to access and correct any of this
information. The Club does not disclose your personal information to any other organization or person unless there is a legal
requirement to do so. Please contact the Club’s Membership Manager if you do not wish to receive marketing and other
information relating to club activities.
Please SIGN here:
Applicant 1 ________________________________________
Applicant 2 ________________________________________
OFFICE USE ONLY
Staff Name
New Membership No’s
Date
Amount Received
App 1 _____________
Photo ID
___ / ___ / _____
Drivers licence/
Over 18 Card
No: ________________________________
App 2 _______________
ID Expiry Date: _______________________________