CLUB MEMBERSHIP APPLICATION FORM Web Site Date of Application Name and Surname Date of Birth ID Number Mobile Number Work Phone Home Phone Email Address Address where Applicant Resides Silver Lakes Resident * YES NO Stand / Erf Number BANKING DETAILS Membership you are Applying for * Please Select an Option GOLD - Family Package (GLD01) - 38,500.00 GOLD - Combined (GLD06) - R31,600.00 GOLD - Full Gold (GLD02) - R22,200.00 GOLD - Lady Full (GLD04) - R16,400.00 GOLD - Under 35 (GLD10) - R15,800.00 GOLD - Week Day (GLD11) - R14,000.00 GOLD - Senior 60+ (GLD07) - R15,200.00 GOLD - Senior +10 Years (GLD07+10) - R8,200.00 GOLD - Junior (GLD08) - R5,900.00 GOLD - Student (GLD05) - R8,400.00 SILVER - Full Silver (SIL01) - R14,000.00 SILVER - Lady Member (SIL03) - R8,900.00 SILVER - Under 35 (SIL04) - R8,500.00 SILVER - Senior 60+ (SIL02) - R8,800.00 GOLF CARTS 2023 - R260.00 If you are a Student, please submit a copy of your Student Card Will you be paying by Debit Order? * YES NO Copy of Debit Order form handed in? * YES NO Affiliation Paid? * YES NO Joining Fee Paid? * YES NO GOLF CART DETAILS Do you own a Golf Cart? * YES NO If YES, cart registration number Colour of Cart Has annual Cart Registration been Paid? YES NO Registration for carts valid from 1 Jan - 31 Dec SPOUSE / PARTNER INFORMATION IF JOINT MEMBERSHIP, FAMILY Name and Surname Date of Birth ID Number Mobile Number Work Phone Email Address INFORMATION OF PREVIOUS CLUB Name of Previous Club Phone Number Address of Previous Club Have you resigned from Previous Club? YES NO Please Note: Should you wish to terminate your golf membership, a letter of resignation has to be received by the Club, one month before your intention to do so, otherwise you will be liable for payments for the full financial year. POPI Act We are committed to protecting your privacy impact and to ensure that your Personal Information is collected and used properly, lawfully, and openly for the following purpose: Golf Membership. We confirm that your Personal Information collected will be used and disposed of as is required by the Protection of Personal Information Act No. 4 of 2013 (POPI Act). Human Verification
