Social Membership Application Form 2024/25 Title Given Names Surname Home Address Postal Address If different to Home Address Email Address Phone (Home) Mobile Date of Birth Occupation Social Membership Options Social Membership Options PLEASE NOTE: There is an additional $49 admin fee for all 7 day and 6 day memberships. 6 Day memberships exclude Saturdays. 1 Year - $6 3 Years - $15 Date Photo ID Type & No. PRIVACY STATEMENT PRIVACY STATEMENT The Antill Park Country Golf Club Limited is subject to the provisions of the Privacy Act 1988 and the Privacy and Personal Information Act 1998. The personal information provided by you on this application form and attached documents will be used to process your membership application. It is a requirement of membership that this application form is completed and failure to provide all of the requested information may result in your application being rejected. You have a right to access and correct any of your personal information that the Club holds about you. The Club does not usually disclose your personal information to any other organisation or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure. Your personal information may be used by the Club for marketing purposes to improve our services and to provide you with the latest information about those services and any new related services and promotions. I agree Signature Declaration: I, the person correctly described above, would like to become a member of the Antill Park Country Golf Club Limited, in accordance with the Constitution and agree to abide by the Rules and By-laws of the Club and have read and understand the Privacy Statement. SaveClear 13 + 1 = Submit