Online Membership Form

By submitting this form via email and applying for membership, you agree to be a member of the Muriwai Golf Club Incorporated Society.

First Name
Last Name
Are you   or ?  
Street Address
Home Phone Number
Post Code
Work Phone Number
Fax Number
Mobile Phone Number
Email Address
Date of Birth
Are you currently a member or have you ever been a member of a Golf NZ affiliated golf club?
Your occupation
Introduced By (Member):
Are you a New Zealand Citizen?
Membership Type Requested

Privacy Statement
The information collected in this form will be used in accordance with the principles of the Privacy Act of 1993. The information will not be used for any other purpose than for a lawful purpose connected to the Club. By submitting this form, you acknowledge your rights to view and amend the information.