ZWARTKOP APPLICATION FORM Personal Detail Membership Type / Tipe Lidmaatskap Full Name * Title * Surname * ID Number * Date of birth (dd.mm/yyyy) Students - name of University/Technicon/College: If Junior - name of school: Grade: Domicilium address * Postal Addres / Posadres * Code/Kode * Telephone No : Home Telephone No : Cell Telephone No : Work Fax E-mail * Telephone No : Emergencies Telephone No : Next of kin Name of Employer : Telephone No : Employer Has your membership ever been refused or terminated by any Club?     Agreement: If elected to membership, I hereby subscribe to and agree fully to abide by the rules and regulations in terms of the Zwartkops Country Club. Should I resign my membership of the Club, I accept that membership fees paid to the end of the year are not refundable. In addition, I undertake to advise management IN WRITING of such resignation.     Date / Datum:   (dd.mm/yyyy) Terms and Conditions - Click Here to Read I have read and agreed to the Terms and Conditions