Passport Photo, Max. 2MB (required)
Name (required)
Surname (required)
Email (required)
Mobile number (required)
Home number
Work number
Postal Address (required)
Home Address (required)
ID/Passport number (required)
Date of Birth (required)
Membership Type (required) ---Full MemberCombined Full MemberFamily MembershipCountry Member (>80km)Combined Country Member (>80km)Student MemberJunior Member (14-18yo)Retired Full Member (>65yo)Retired Combined Full Member (>65yo)Honorary, Honorary Life or Life Member
I have attended the following official meets of the Eastern Province Section : (Meet descriptions, Date, Leader's name) 1. Meet Description: Leader:
2. Meet Description: Leader:
3. Meet Description: Leader:
Proposer (full name)
Email
Seconder (full name)
I submit my motivation to join the club : (A motivation describing yourself as an active and responsible mountain user, explaining why they feel they fit in with the ethos of the MCSA)
1. Motivation
2. Testimonial from Proposer
Have you ever been or are you a member of any other Section? ---YESNO Have you ever been refused membership of any other Section? ---YESNO Are you prepared to participate in rescue work? ---YESNO
I agree to abide by the Constitution and Rules of the Section
Date (required)
Signature (required, sign in the rectangle below) [signature* signature-applicant cols:300 rows:200 color:Black background:Yellow]