Nomination for Associate Membership Form

Name: Darwin Email: kongzkie_1@yahoo.com Address: mintal davao city, Suite number, intersection, plaza, square Home: 3123 Mobile: 123 Occupation: sample occupation Date of Birth: May 4, 4 1995

Declaration: I hereby apply for membership of the Dunedin Returned and Services’ Association and certify that the information given herein is correct. I undertake to abide by the Constitution and Rules of the RSA. I have never been expelled or rejected from membership of any other branch of the Returned and Services’ Association organisation.

Proposition:We, the undersigned, being financial members of the Dunedin Returned and Services’ Association, hereby nominate the above named applicant for membership of the association. We believe this person to be a fit and proper person, of good character, and possessing the necessary qualifications for membership.

Proposer: How long have you known the applicant? __________________ years
Proposed by: ____________________ Signed:________________ Date: ________________
Seconder: How long have you known the applicant? __________________ years
Seconded by: ____________________ Signed:________________ Date: ________________

Committe use only

Date application received: __________________________
Committee Members to Initial: 1.) ______________ 2.) ______________
Accepted/Declined
Accepted/Declined
(delete as applicable)
(delete as applicable)

Committe use only

Letter sent date:________________
Amount due: ______________ Amount Payed: ______________ Date: _______________
Card Number: _______________________ Card and Badge sent date: ______________________
Application complete – Secretary signature ___________________________ Date ______________________