Nomination for Associate Membership Form
Date of Birth: December 19, 19 1983
Marital Status: Married
Spouse / Partner’s Name: d
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 Returned Serviceman/Servicewoman
for membership of the association. We believe this person to be a fit and proper person,
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: ________________