PSPL REFORM GROUP INCORPORATED

Incorporated in Victoria under

the Associations Incorporation Reform Act 2012

Registered no. A00059199H

www.psplreformgroup.com email:

Payment: CHEQUES should be made payable to Graeme McIntosh as Trustee for PSPL Reform Group Inc and with form sent to:

Deputy Treasurer, PSPL Reform Group Inc. 4 Pacific Parade, Army Bay, Whangaparaoa 0930,

ELECTRONIC TRANSFER: ASB Bank Ltd (Whangaparaoa Branch) Account No 123084 0231933 suffix 52 A/c Name: Graeme McIntosh as Trustee for PSPL Reform Group Inc

Reference: Your Club name.

MEMBERSHIP APPLICATION FORM

FOR UNINCORPORATED NEW ZEALAND

CLUBS & ASSOCIATIONS

Class of Membership applied for / Mark box
below
UNINCORPORATED CLUB MEMBERSHIP
UNINCORPORATED ASSOCIATION MEMBERSHIP

Note: do not use this form if you wish to apply for Incorporated Club Membership, Incorporated Association Membership or Individual Membership.

I, the applicant named below,

(a) wish to become a member of PSPL Reform Group Inc. (the Group); and

(b) support the purposes of the Group; and

(c) agree to comply with the Rules of the Group;

(d) am authorized by resolution of the committee of the Club or Association named below to apply for the membership on behalf of that Club or Association; and

(e) will hold the membership in trust for the Unincorporated C lub or Association while it remains unincorporated.

Applicant:
Full name of Club’s or Association’s President who will hold membership as trustee and agent for the club or association / Membership will be registered in this person’s name “for” the Club or Association named below
Name of Club or Association
Name of contact person
(e.g. the Secretary)
Address of contact person
Email address of contact person
Phone number of contact person

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Continued from p.1

Have you attached a cheque for the $NZ 22.00 joining fee or paid by Electronic transfer?
Signature of President of Club or Association

PLEASE NOTE THESE EXTRACTS FROM THE RULES OF PSPL Reform Group Inc.:

(4) The President for the time being of an unincorporated Club is eligible to apply for Unincorporated Club Membership, and, if accepted, will hold the membership in trust for and as agent for the unincorporated Club while it remains unincorporated until a successor in office of that President becomes an Unincorporated Club Member in his or her place as provided in subrule (7).

(7) In the case of an Unincorporated Club Membership or an Unincorporated Association Membership, when the President holding the membership ceases to hold office as President, the succeeding President shall give notice to the Group of the change of office and the Group shall register the successor as the holder of the membership in lieu of the former President.