New Member Registration

Apex Club:
Which club would you like to register in?*
Apex Club Email Address*

New Member Details:
Given Names*	Surname*
Name on Badge*	Partners Name
Address*
Suburb*
State*	Postcode*
Email*	Mobile*
Home Phone	Work Phone
Date of Birth*	Occupation*
Membership Category*
Is the proposed member, currently, or has been, a member of a similar organisation?*
If so, please provide details:
Nominated by*	Seconded by*

Terms:
I hereby agree to accept membership of the Apex Club named above and I have been fully informed of the rules of this Club and those of the Association generally. I agree to abide by them and uphold the integrity of the Association. I understand that, if the Club or National Board at any time consider my actions contrary to such principles, my resignation may be requested and/or my membership terminated as per the Club or Association Rules as applicable. I also understand that I must regularly attend club meetings and social events, participate in service work and invite others to share in the Apex experience. I agree