PRESIDENT: Garry Dick ph: 0427 009 266
SECRETARY: Graeme Morley ph: 0418 734 825
TREASURER: Diane Morley ph: 0477 660 065
The Secretary
Marine Rescue Bundaberg
PO Box 566
Bundaberg QLD 4670

RADIO BASE
PHONE: (07) 4159 4349
FAX: (07) 4159 4389
EMAIL:
A.B.N. 72 249 925 594

Application for VMR Membership

PARTICULARS OF APPLICANT
* Name: * Phone (H):
* Address: Phone (W):
Mobile:
Occupation: * Email:
TOWING VEHICLE DETAILS
Make: Model: Colour:
Registration: Trailer Registration:
BOAT DETAILS
Vessel Name: Length (metres):
Registration No.: Hull Colour:
Make (eg Haines): Deck Colour:
Type (H/Cabin): Construction Material:
COMMUNICATION EQUIPMENT
27 Mhz Radio VHF Radio EPIRB HF Radio
* I hereby apply for membership of Volunteer Marine Rescue Bundaberg Inc. Should my membership be accepted I herby agree to abide by the constitutional rules, by-laws and standard operating procedures as determined from time to time by the management committee.      Agree:
FEES
Annual Membership Fee: $ includes GST
Optional Partner: $5.50 includes GST       Partner Name:
* Optional Annual Boat Levy: $
* Optional Donation: $
TOTAL: $ includes GST
* Boat levy: $22.00 allows $100.00 towing costs, $44.00 allows $200.00 towing costs, $66 allows $300 towing costs,
$88 allows $400 towing costs and $110 allows $500 towing costs.

Tick box if you wish to be an active member
NB: Subject to interview and placement - a commitment to training may be required

             
Fields Marked * are required

Copyright © 2011 VMR Bundaberg