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: ______/______/_________
Occupation:
(optional): ___________________________________________________
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.

Membership type Receive newsletter by Enter amount
Email only Post
Family $50 $60
Adult $35 $45
Junior (<20y) $20 $30

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)