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MEMBERSHIP APPLICATION
 
Personal Details
* required
  First Name: *
  Last Name: *
  Date of Birth: *
  Email:*
  Address: *
  City: *
  State: *
  Post Code: *
 
 
Privacy
 
  The Camarilla Australia abides by the Privacy Act and Privacy Principles of Australia. The Organization will not pass any of your details except when required by law, or for the necessary operations of the club.  By joining the Camarilla Australia, you agree to this use of your information.
  The Affiliation Agreement with White Wolf, Inc requires us to pass on the full name, address and electronic mail address to White Wolf, Inc annually, and when requested. By joining the Camarilla Australia, you agree to this use of your information.
  For the smooth operation of the club, Position Holders within the club are required to have access to your personal information. Also, by participating in Camarilla mailing lists, your email address will be available to all other members of those lists.
  Please do not pass my personal details outside of the Camarilla Australia
(NB: In joining the White Wolf Fan Club of Australia Inc., you agree to White Wolf, Inc. being provided with your full name, membership number and membership expiry date. Your other personal details will only be shared if you choose not to tick this box.)
  Please do not pass my personal details to non-coordinators within the Camarilla Australia
(NB: Choosing to subscribe to any sanctioned Camarilla mailing list overrides the option to keep your email address private. Position holders should also be aware that they need to make some personal contact information public to facilitate communication between the many levels of the club. If you do not tick this box, the White Wolf Fan Club Australia Inc has permission to pass your personal details to any other member who asks.)
  Write the text in the image here:* Hint: The last digit is a six...