APPLICATION FOR ASSOCIATE
MEMBERSHIP OF
THE ATLAS CLUB Inc
I hereby wish to apply for Associate Membership of The
Atlas Club Incorporated and its associate clubs
All of the information supplied on this application form is protected under our Privacy
Policy and the Privacy Act and will not be made
available to any other party. This information is stored off-line and cannot be
accessed by unauthorized persons or
via the net.
*
The Information marked by a RED asterisk must be supplied or your application
may not proceed.
|
| Your
First Name*/Middle
initial*/Last
Name (surname)*:
First and last names must be in full not initials
|
|
| Your
Spouse/partners's First name /Last Name:
|
|
| Street
Address*
This must be your personal address not a work or business
address
| |
| 1.Suburb*
2.city*
| 1
Suburb2 City. |
| 1.State*
2.Post Code*:
| 1.
State
2.Postcode |
| Country*:
| |
| Home
Phone Number Code/number*
|
|
| Mobile/Cell
phone Number*
| |
| Email
Address:*
Atlas deals &
information are only disseminated by email to members, so
make
sure your email address is correct or you will not get a response.
| Your
personal email address
Enter your email address again*
This second step automatically enters you into
our comps |
Your
Date of Birth dd/mm/yy*
You must be over 18 yrs of
age
| |
| Is
a Club Member sponsoring you? Please provide
the First Name/Last Name & Membership Number*
of the Atlas Member who is sponsoring you
into the Atlas Club
|
|
| How
did you find out about The Atlas Club?
| |
| If
you located us through the internet site which website was it?
| |
| *The
Atlas constitution requires that all new members are to be
sponsored by an existing Atlas member. If
you do not know an Atlas Member to sponsor you, leave the
above space blank and a Club Director will sponsor your
application . |
*Please
Select the
Club Activities that are of interest to you
|
| *It is essential that you select,
the club activities that are of interest to you.
Unless you do this, there is no point in joining the club, because
we do not publish sensitive information on our activities at our
website. Club information is meant to be viewed by members only and is
therefore sent direct to you by email. |
| Domestic
Travel
|
| Atlas
Comedy Club
| |
| Accommodation
Specials
|
| Atlas
Movie Club
| |
| Domestic
Holidays
|
| Wine
& Food Club
| |
| Short
Breaks
|
| Competitions,
Trivia, Games
| |
| Domestic
Charters
|
| Atlas
Bargain Bazaar
| |
| Cruises
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| Atlas
Computers & Software
| |
| International
Travel
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| Entertainment,
Parties, Excursions
|
|
| Travel
Cash Reward Points (our unique rewards
points Program)
|
| Atlas
Insurances
| |
|
|
|
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I
declare that I am 18 years or older and I understand that
Associate Membership to The Atlas Club Inc is FREE and that
by clicking on the "Submit" button below signifies that
I have agreed to be bound by the Club's rules
and constitution.
Do you Agree?
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