Queenscliff Golf Club Membership Application Form 2019 Membership Year All our memberships run from 1 March and are pro-rata.For more information on membership types, visit our website.Applicant Details Question Title * 1. Please indicate the membership type*: Full Member - $1195 Senior Member - $950 Junior Member - $150 Country Member - $920 Lifestyle Core - $750 Lifestyle Social - $250 Social - $55 Question Title * 2. Your details: Full Name Phone Number Email address Question Title * 3. Address (street address / suburb / post code) Question Title * 4. Date of Birth Enter your D.O.B. Date Question Title * 5. Emergency contact full name and phone number: Question Title * 6. Do you hold an existing Golf Link Number? Yes (please include Golf Link Number below) No Golf Link Number Question Title * 7. Do you want to make QGC your “Home Club” for handicap purposes? Yes No By submitting this form I agree to abide by the Constitution and By Laws of Queenscliff Golf Club.All payments include GSTPAYMENTI permit the Queenscliff Golf Club to deduct the amount, listed next to my selected membership type above, for my initial membership fee using the following credit card details: Question Title * 8. Credit card details: Type of card (Visa/MC only) Name on card Card number Expiry (MM/YY) DONE!