Membership : Online Form

To Apply for Membership at Southport Golf you must complete an application form.

A hard copy can be download to print out and complete: Click Here to Download Application Form

Or you can use the online form below:

Please complete the following
Title	Mr Mrs Miss Ms Master Dr Sir Lady Rev	Surname
Initials		Given Name(s)
Preferred Name		Date Of Birth
Address
Suburb		Postcode
Phone (Hm)		Phone (Wk)
Phone (Mb)		Fax
Email
Occupation		Employer
Work Address
Permanent Resident of the Gold Coast?	Yes No	Number of Years
Visa		Permanent	Pensioner
Next of Kin		Relationship
Next of Kin Phone
Membership Type	Please Select Ordinary Associate Membership Limited Play Membership Intermediate Membership - 18 years Intermediate Membership - 19 years Intermediate Membership - 20 years Intermediate Membership - 21 years Intermediate Membership - 22 years Junior membership
If the nominated category is closed, do you wish to enter a lesser category until vacancies become available?			No Yes
Details of other sporting and social club membership past and present
Golf Experience
Handicap		Golf Link No.
Home Club
Have you ever been refused membership at any other club?			No Yes
If applicable - Members of Southport Golf Club that will support my nomination
Proposer		Seconder
Period known		Period known
Name and Contacts of 3 Referees:
1. Name:		Phone:
2. Name:		Phone:
3. Name:		Phone:
How did you find out About Southport?
Please Select	Select Member Newspaper Radio Internet Location Other
I hereby agree that, if elected, to abided by the Rules and By-Laws as laid down in the Memorandum and Articles of Association in force at present, or may be decreed in future by the Committee of Management
		Please type the text from the image to the left or click here if you cannot read the image.
Acceptance of the application is conditional upon being accepted by the management committee