membership renewal form - monarto metallic silhouette rifle club

SSAA MONARTO METALLIC SILHOUETTE
RIFLE CLUB
MEMBERSHIP RENEWAL FORM
In order to renew your membership you are required to ensure the following is
completed
Complete membership renewal form
Provide a copy of your current SSAA SA membership
Paid membership fee via bank transfer/ Cheque or Money Order
1. Member Details:
Name:
Address:
Postcode:
Email:
Phone:
Mobile No:
My phone number can be provided to other club members if requested
YES
NO
2. SSAA Membership:
To be a MMSRC member, a current SSAA SA membership is compulsory.
Please provide a copy of your current SSAA SA membership card to the club's secretary
SSAA Membership
No:
Expiry Date:
3. Membership Fees:
Type of Membership (Please tick one)
$84.00 for ordinary and family membership
$60.00 for pensioner membership
Membership Renewal fees are due to be paid by 30th September each Year
(Joining fee and new police requirement may apply for members that fail to renew membership timely)
Method of payment (Please tick one)
SSAA MONARTO METALLIC SILHOUETTE
RIFLE CLUB
MEMBERSHIP RENEWAL FORM
Please find enclosed my cheque/ money order
Please make cheque/money order payable to "Monarto Metallic Silhouette Rifle Club Inc"
I have paid $
directly in the following Bank Account on the
Bank:
People’s Choice Credit
Union
Account Name:
MMSRC INC ACCESS a/c
BSB Number:
Account
Number:
/
/
805-050
100094694
Reference
used:
Please either use your SSAA membership number or your name as the reference
Once you have completed the membership renewal please post to:
The Secretary
PO Box 267
SEAFORD SA 5169
If available please email this form and SSAA
membership to: 'Peter Milazzo'
<ppgdelta75@gmail.com>
Privacy Statement
The information on this form is collected and stored for the management of the club and its activities. It will be made available to
committee members. It will also be provided to various members from time to time when necessary for carrying out club duties.
The club will also release information to comply with legislative requirement and with membership conditions of SSAA. Club
policy is not to provide members information to organisations, businesses, agencies or individuals outside of these guidelines.