NCGC MEMBERSHIP APPLICATION FORM

APPLICANT/S INFORMATION
Name:
Gender : Male Female (Please Tick ) Mobile:
Current Address:


Email:
Age Bracket (Please Tick ) Marital Status (Please Tick ) Membership Type (Please Tick )
18-25 26-40 Above 41 Single Married

Student Single / Adult Family Life

SPOUSE INFORMATION (IF FAMILY MEMBERSHIP)
Name:
Age Bracket: (Please Tick ) 18-25 26-40 Above 41
CHILDREN (IF ANY)
Name Age
Name Age
Name Age
Name Age
TERMS AND CONDITION
By applying for membership of Nepalese Community Gold Coast Inc. you are agreeing to abide by the rules and regulation of the Nepalese
Community of Gold Coast Inc.
Signature of the main applicant: Date:

Payment Details:

By Bank Deposit:

BSB: 064430 Account Number: 1119 1271

Account Name: Nepalese Community Gold Coast Inc

NB: Please mention your full name under recipient description for identification.

By Cash:
Please request for receipt if you are paying cash to one of the NCGC committee member.


OFFICE USE ONLY

Membership Fee Received: $




Verified by Treasurer ( If via Bank Deposit) :



Received By (if Cash) :



Membership No. Granted -