2016 - 2017

Membership Application/Renewal
23 Marieville Esplanade
Sailability Tasmania Inc Sandy Bay
A deductible gift recipient TAS 7005
ABN 24 456 336 156 www.sailabilitytas.org/
sailabilitytas@gmail.com
Personal Information
First Name Family Name

Street Address/PO Box City Postcode

Email Date of Birth List any skills you may have that
you believe may be useful to
Sailability!

Mobile Home Phone Work Phone

Are you a member of YA Member Number Do you have a Motor MAST/Other Licence Number
Yachting Australia? Boat Licence?
YES YES YES
NO NO

Do you have a Working With Children Card? WWC Card Number

YES NO
Membership
Member (Voting $20 OR Associate Member $10

New Member Application

Rights)
1 Print Name Signature of Nominee

Nominees
2 Print Name Signature of Nominee

I hereby apply to become a member of Sailability Signature of Applicant or Renewing Member Date
Tasmania Incorporated. In the event of my
admission as a member, I agree to be bound by
the rules of the association for the time being in
force and agree to abide by all decisions made by a
committee member.

Payment Methods
Direct Deposit Cheque by Post to
Commonweath Bank Treasurer
BSB: 067103 Sailability Tasmania 14A Poets
Account No: 1028 Road West Hobart TAS 7000
1828 Please include completed form.
Include family name and
initials as reference -
completed form can be
sent by email or post.