CF7
Nomination for Associate Membership Form
Name: Kimberley Elliott
Email: kimberleyelliott434@gmail.com
Address: 21 Douglas Street, Saint Kilda, Dunedin 9012
Home: 034553187
Mobile: 0274417640
Occupation: Student
Date of Birth: April 14, 14 1999
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 ____________