Membership Application Form

Want to Join the Club?

Members
Update your details

Download a
printable form

Don't have Adobe Acrobate?
Click icon below to download a free copy

Application for Membership (new member).
If you are a current member and wish to renew your membership, click here.

Full name

Street

Suburb

Postcode

Date of birth

Other club membership

Phone (home)

Phone (business)

Phone (mobile)

E-mail

Signature*

Date

* By entering your name here, you are stating that you are applying for membership to the Little Ship Club.

Application for associate membership

Full name

Relationship to proponent

Ship register

Name of vessel

Cruising speed

L.O.A.

metres

Type

Light power craft
Trailer sailor
Cruiser (motor yacht)
Sailing Yacht

Proposer*

Signature

Date

Seconder*

Signature

Date

* I have been a member of the club for more than 12 months. The applicant is personally well known to me and I recommend acceptance of this application for membership.

Payment to accompany this application
Please make cheques payable to "Little Ship Club" or complete the following for payment by credit card and post to: The Little Ship Club, 1 Yabby Street Dunwich QLD 4183.

DO NOT include your credit card details here if submitting this form over the web. Instead, you will be taken to our fully secure server when you click on the Submit via Internet button below.

Card type

Mastercard
Visa card

Card number

Expiry Date

Amount due*

Signature

Date

* Fees
ALL PRICES
INCLUDE GST

Nomination fee: $181.50
Full member: $143.00 p/a
Senior rate: $71.50 p/a
Associate member: $6.00 p/a

Large Burgee: $33.00
Small Burgee: $22.00
Club Tie: $25.00
Tie Pin: $8.80

Clicking the submit button more than once will result in multiple orders.

Alternatively, you can print out this page and submit by mail
To print, click on the 'Print this page' button below

To pay your Membership Dues via secure internet server
using your credit card, just click on the Submit via Internet
button above (after completing all details) and this will take
you to the next page where you can safely input your credit
card details via our fully secure server.

Website Design & Maintenance: Australian Web Design