AffiliateMembershipForm – Melton RSL Sub-Branch

Title

Name

First Name

Middle Name

Last Name

Post-Nominals

Eg. DSC, AM, CSM. If applicable. Post Nominals does not include Professional Credentials such as CPA.

Gender

Date of Birth

Residential Address

Please include street number, street name, city/suburb, state & postcode. Reference the example above.

Postal Address

Leave blank, if same as Residential Address.

Mobile Phone Number

Home Phone Number

Include area code. Leave blank if not applicable.

Business Phone Number

Include area code. Leave blank if not applicable.

Email

Identification

The personal information provided on this membership form will be used in accordance with the privacy policy adopted by the Victorian Branch of the Returned & Services League of Australia. This Policy is freely available and can be accessed via the Victorian Branch website at: www.rslvic.com.au or upon request.

Type of Identification

ID Number

Identification Documents Country of Issue

State/ Province of Issue

Identification Document Date of Issue

Identification Document Date of Expiry

Next of Kin

First Name

Last Name

Next of Kin Contact Number

Next of Kin Relationship to the Applicant

Criteria satisfied for Affiliate Membership:

I am the relative of a person who is, or was, eligible to be a Service Member of the League

I am or was a member of the Emergency Services (Police, Fire Brigade, CFA, Ambulance, SES) for more than 6 months.

Veteran’s Full Name

If you are applying for Affiliate Membership on the basis you are related to a person who is, or was, eligible to be a Service Member of the League, please provide your relative’s full name.

Relative’s Service Details

If you are applying for Affiliate Membership on the basis you are related to a person who is, or was, eligible to be a Service Member of the League, please provide your relative’s relevant service history.

Veteran’s Service Number

It is necessary to provide your relative’s Service Number who is a veteran. Your application for membership cannot be finalised otherwise.

Relationship to Veteran

If you are applying for Affiliate Membership on the basis you are related to a person who is, or was, eligible to be a Service Member of the League, please provide your relationship.

Emergency Service History

If you are applying for Affiliate Membership on the basis you are or were a member of the Emergency Services for 6 months or more, please indicate which Emergency Services you are or were, a member of.

Are you currently a member of any RSL Sub Branch?

Yes

No

Are you applying for a Transfer of Membership?

Yes

No

Consent to Contact

I consent to being contacted by a representative of the Melton RSL Sub-Branch, the League, or an authorised third-party representative of the Melton RSL Sub-Branch and/or the League.

Privacy Statement Acknowledgement

The personal information provided on this membership form will be used in accordance with the privacy policy adopted by the Victorian Branch of the Returned & Services League of Australia. This Policy is freely available and can be accessed via the Victorian Branch website at: www.rslvic.com.au or upon request.

Declaration & Agreement

I declare that (1) the information provided is true and correct; (2) I agree to uphold the Constitution of the League and its By-Laws; (3) I understand that as a member I will receive information about RSL events, activities and offers from the RSL and its business partners.

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Melton RSL Sub-Branch

AFFILIATE MEMBERSHIP APPLICATION

Affiliate Membership