BOAT OWNERS' ASSOCIATION OF NSW (INC) MEMBERSHIP APPLICATION

Please complete this form, print it, sign it, and either mail, fax or - for Credit Card payments only, scan and email to:
Membership Secretary, BOA NSW
P.O. Box 212,  Spit Junction  NSW  2088
Fax: (02) 9960 1859
Email: membership@boaters.org.au

 

Surname

 First Name/Initial

Title (Mr/Ms/Mrs/Miss/Dr etc)

Occupation (Optional)

Street Address

Postal Address (if different)

Suburb / State / Postcode

Suburb / State / Postcode

Phone number

Mobile Number

Fax number

E-mail Address
Fees

New Subscription - $10 Administrative Joining Fee

 $
Membership Fee - click nominated selection
$

Additional Contribution - optional

 $

Total Fees payable:

 $

Payment Method

Card Type

Credit Card Cheque Money Order

Mastercard Visa

Card Number

Expiry Date (month/year)
Total Credit Card Amount Name as shown on your card
$
Vessel Details

Boat Name

Vessel Registration No. (NSW Maritime)

Length

Type

  Trailer  Moored     Sail  Power

Location of mooring (eg, name of bay)

Mooring Number (if applicable)

Signed

Date
________________________________________________ ________________________________________________