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Please complete the below form to apply for Club Membership. Once we have confirmed your eligibility to join we will contact you to complete the application and process your membership fees. For further information on membership please visit our membership page or call Club Reception on 6488 8770.

MEMBERSHIP APPLICATION

Category*
If you do not fall under any of the below categories, please contact Club Reception on (08) 6488 8770 to determine if you are eligible for Non-Standard membership.
Staff Number / Student Number / Partner’s Member Number/ Proposing Members Membership Number/Local business name/Name of employing university.*
Please provide the applicable detail for your membership category.
University = UWA Staff Number;
Associate = Spouse or Life Partner’s Member Number;
Individual, Young Alumni, Postgraduate, parent/Granparent of existing student = UWA Student Number Friend or Family of Existing Member = Proposing Members Membership Number
Name*
First Last
Preferred Name
Gender
Date of Birth*
DD slash MM slash YYYY
Home Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Postal Address (if applicable)
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Phone Number*
Mobile*
Occupation*
Company*
How would you like to receive information?
Notes
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