Title

First Name

Surname

Western Province No.

ID Number

Address

Street

Suburb

Town

Gordons Bay Kuilsrivier Select Town Somerset West Stellenbosch Strand

Code

Cell

Home

Work

Fax

Email

Receive emails

Yes

No

Membership Type

Junior R100 per month Junior R1200 per annum Senior R150 per month Senior R1800 per annum

I hereby declare that the above information is true. I have never been convicted of any offence under the Nature Conservation Laws of any country. I apply for membership of the Falsebay Rock & Surf Angling Club, and if I am elected, I will conform to, and abide by, the Rules, Constitution and Regulations of the Club.

I understand that acceptance of this application is at the sole discretion of the Committee of the Falsebay Rock & Surf Angling Club and that if my application is not accepted, the fee's paid by me will be refunded

Accept these terms

Yes

No