Membership Application Form

Please enter your contact details below

First Name *

Last Name *

Street / PO Box Address *

Suburb / RD No *

City / Town *

Postcode *

Email *

Postal Address (if different from above)

Phone *

Mobile *

PAYMENT DETAILS (please tick all that apply)

I would like to make a tax deductable donation of

I will make payment of my membership subscription fee of $80.00 by Direct Credit to: ASB 12-3144-0170504-00

Donation - Value

** Membership subscriptions are valid from the date the membership subscription payment is received by HBVCG until 4 weeks after the next AGM. AGM’s are normally held in late August **

Please enter details about your vessel below

This information will be used to aid Hawke’s Bay Volunteer Coastguard when assisting you on the water.

Vessel Name

Vessel Size

Hull Colour

Cabin Colour

Equipment on Board

Other Equipment on Board

Callsign

Engine Type

Inboard

Outboard

Engine Size (hp)

Vessel Construction

Aluminium

Steel

Fibre Glass

Wood

Vessel is

Vessel is at Other

Trailer Rego No

Are you a member of

Select all that apply

HB Sports Fishing Club

Napier Sailing Club

Clifton Sailing Club

Hawke’s Bay Volunteer Coastguard will not pass any of this information on to a third party, other than the Police during an emergency.

Membership details that require changing need to be emailed to info@hawkesbaycoastguard.co.nz

Membership Application Form

Please enter your contact details below

Please enter details about your vessel below

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