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)

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:

I have attended the following Thursday evening social :

Have you ever been or are you a member of any other Section?
Have you ever been refused membership of any other Section?

Are you prepared to participate in rescue work?


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]


Proposer and Seconder to be Honorary, Full or Life members of more than 2 years standing. Typically they are the hike leaders of the hikes you have attended.
One preferably to be a current Committee Member.

Proposer (full name) (required)

Email (required)

Seconder (full name) (required)

Email (required)