MTSC Application for Membership

Print out and send with subscription to:
The Membership Secretary, Manawatu Tramping and Skiing Club. PO Box 245, Palmerston North.
Please make cheques out to "Manawatu Tramping and Skiing Club Inc", or see http://www.mtsc.nz for details about Internet banking.

Full Name: ___________________________________________________
Address: _________________________________
City: ____________________
Phone (Home) (____) _________      Mob: (____) _________       (Work) (____) _________
Email: _____________________________________
Date of Birth: ______/______/_________

Applicants signature:

___________________________________________________

A Family Membership may include you, your partner, and children under 20 years all living at the same address. Juniors must be under 20 years old.

For a Family membership, please enter the names and dates of birth of other family members:
_________________________________________________________________/_____/_____
_________________________________________________________________/_____/_____
_________________________________________________________________/_____/_____
_________________________________________________________________/_____/_____

Emergency Contact: (Someone who should be contacted if there is an emergency)
Full Name: ___________________________________
Address: __________________________
Phone: (____) ___________      Mob: (____) ___________
__________________________

Indicate any previous /membership of any Tramping, Skiing or Outdoor clubs:
______________________________________________________________________________
______________________________________________________________________________

Please list any skills, craft or profession that you are prepared to use for the benefit of the Club:
______________________________________________________________________________
______________________________________________________________________________

Proposer:_____________________________(sign) _______________________________(print)

Seconder:____________________________(sign) _______________________________(print)
(Proposer or seconder must have been current members for at least one year)