Observatory Golf Club Application for Membership

Observatory Golf Club Application for Membership
Name *

First Name Last Name
Initials *
Title
Postal Address *

Street Address

Street Address Line 2

City Province

Postal Code
Date of Birth (yy/mm/dd) *
Age
ID Number *
Tel Number Home

Area Code Phone Number
Tel Number Work

Area Code Phone Number
Cellphone *

Area Code Phone Number
E-mail address *
Previous Golf Club (If applicable)
Membership Type *

Full Member (36-65 years): R6 207.00 Full Member - Senior (>65): R3 860.00 Full Member (19-35 years): R3 827.00 Full Member - Junior (under 18): R850.00 Handicap Membership (Includes affiliation and HNA): R1 249.00
Monthly debit order (not applicable to Full member - Junior and Handicap memership categories)

yes no
Amount (Rands) to be debited monthly
All memberships include affiliation costs

Junior, student and handicap members can add the PMG Lite option for an additional R400

Only Full membership (36-65 years) includes PMG Lite
I, the above named, hereby apply to join Obs Golf Club (Pty) Ltd, Johannesburg. I undertake to abide by all the rules and bylaws of the Club as laid down from time to time. I fully understand and agree to the terms and conditions of this membership. I confirm that should I wish to resign, I will notify the club within one (1) full calendar month in writing and failure to do so will result in my being liable for the full year's subscription. If a membership is ultimately cancelled, no refund of the year's fees will be made. *

I agree
Date signed

Day Month Year
Date
Initials and surname *
Should be Empty: