25 Wellington Street, HOWICK
ph (09) 534-9702

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Application for Returned Serviceman


Service Number
Surname
War Served In
First Names

Year of Joining
Force Served With
Date of Discharge
Rank on Discharge
Where Served
Type of Membership
Date of Birth
Next of Kin


Phone Number:


Address:


Suburb:


Post Code:


Email Address:



In joining this Association I undertake to abide by its constitution and rules and hereby declare that I have not been expelled or rejected for membership of any other Returned Services Association.  I hereby apply to be enrolled as a member of the Howick RSA Inc and agree to abide by its rules.