CF7
Nomination for Associate Membership Form
Name: 123
Email: darwinemnacelayague@gmail.com
Address: dd
Home: 123
Mobile: 123
Occupation: sample occupation
Date of Birth: March 4, 4 1985
Marital Status: Married
Spouse / Partner’s Name: qe
Branch: 123123
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.
Date:
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: ________________
RSA Returned / Service Application
Service Number: 123123 Service: Other
Service: qwe
Units: 123123 Length of Services: asdasd Rank: asdasd Theatres of Service and Dates: 123123 Medals and Awards: dasd Any other Relevant Services Information 123123 Are you receiving any financial assistance from War Pension Services? No Would you like the RSA Welfare Officer to contact you? No
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: _______________ (if applicable)
Copy to Welfare Officer date _______________ (all successful applications)
Application complete – Secretary signature ____________ Date ____________
Please return to P.O Box 4008, St Kilda, Dunedin