MEMBERSHIP FORM                                                                            DETAILS: PLEASE PRINT CLEARLY
                                                                                           Personal Identification must be presented when making
                                                                                           an application for membership.
Wentworthville Leagues Club Limited
Phone Number: (02) 8868 9200                                                               Address ������������������������������������������
ABN 25 000 244 459                                                                         Suburb �������������������������������������������
                                                                                           ����������������������������������� Postcode ������
I, Mr/Mrs/Ms/Miss/Other �����������������������������
                                                                                           Postal Address (or ‘as above’)
Surname �����������������������������������������                                          Address ������������������������������������������
                                                                                           Suburb �������������������������������������������                      MEMBERSHIP FORM
Given Names �������������������������������������
                                                                                           ����������������������������������� Postcode ������
Preferred Name �����������������������������������
                                                                                           Home Ph �����������������������������������������

Date of Birth ��������������������������������������                                       Business Ph���������������������������������������
I hereby apply for membership of Wentworthville Leagues Club Limited. I agree to           Mobile Ph �����������������������������������������
abide by the Constitution and By-Laws of the Club (a copy is a available at reception).
On completion of this form and payment you will be a provisional member and                Email ���������������������������������������������
subject to the Constitution of the Club. Membership fees are non-refundable unless
your membership is not approved. You will be advised by mail when your application         Occupation ���������������������������������������
has been approved by the Board and you become a financial member. Provisional
members can earn but not redeem bonus points and non-approval of membership
will result in forfeiture of all points. Provisional members may participate in members’   q I would like to receive information on gaming machine promotions
promotions but prizes will not be paid until full membership has been approved.
Please note: Your membership will be due for renewal on the anniversary of your date
of joining. A driver’s licence or equivalent ID is to be photocopied and stapled to your
                                                                                           PROPOSED BY _______________________________
membership form.
                                                                                           MEMBERShIP # _______________________________                              JOIN NOW AND
��������������������������������������������������                                         SECONDED BY _______________________________
                                                                                                                                                                 S TA R T S AV I N G T O D AY
SIGNATURE OF APPLICANT                                                                                                                                          Just $5 for a standard one year membership
                                                                                           MEMBERShIP # ______________________________
DATE ���������������������������������������������

Standard               q 1 Year $5                  q 4 Years $15                          CLUB STAFF USE ONLY
Concession             q 1 Year $2.50               q 4 Years $8.80                        Date Received ������������������������������������
*To become a Concession Member you must supply proof of a
 Commonwealth pension.                                                                     Receipt No����������������������������������������

Junior                 q Junior Sports, 1 Year $2.20                                       Bundy No �����������������������������������������
Staff                  q 1 Year $2.50
                                                                                           Identification ��������������������������������������
Method of Payment
q Cash q Eftpos q Cheque q Credit Card                                                     Membership No �����������������������������������

                              50 Smith Street Wentworthville
                              Phone Number: (02) 8868 9200
Superb food, leading entertainment and friendly staff is
what makes Wenty Leagues such a great club. Food, fun
and fantastic value - You’ll find it all at Wenty Leagues.

Join today and have access to fantastic
member benefits including:
• 10% off at Bars and Restaurants                                • Exclusive member promotions
Receive 10% off food and beverage purchases when you present     Take part in exclusive member promotions for the chance to
your membership card                                             win thousands of dollars and great prizes
Not valid at the Imperial Dragon Restaurant
                                                                 • It’s your Birthday
• Discounted Show Tickets                                        Celebrate your birthday with special offers and promotions
Receive discounts for most shows held at the club, which means
you can enjoy leading entertainment at even better value

To top