RIFT VALLEY SPORTS CLUB

P.O. BOX 1-20100

NAKURU

TEL; 051-2212085 FAX 2213194

EMAIL: rvscnku@wananchi.com

MEMBERSHIP APPLICATION FORM

Date______________

1. Name: Prof./Dr/Mr./Mrs./Miss _____________________________________________________________________

Last Name

Middle Name

First Name

2. Postal Address _________________________________________________________________________________

3. Physical Address ________________________________________________________________________________
Permanent Address: _____________________________________________________________________________
4. Home Tel: _________________________________ 5. Cell Phone: _______________________________________
6. Email Address:- _________________________________________________________________________________
7. Date of Birth: ___________________________

8. Identity Card Number _______________________________

(Please attach a Copy)

9. Marital Status: __________________________________________________________________________________

10. Name of Wife/Husband __________________________________________________________________________
11. No. of Children _________________________________________________________________________________
12. Names/Age of children under 18 years:
a) ___________________________________________________________________________________________
Name

Date of Birth

b) ___________________________________________________________________________________________
Name

Date of Birth

c) ___________________________________________________________________________________________
Name

Date of Birth

d) __________________________________________________________________________________________
Name

Date of Birth

13. Nationality __________________________Country of Residence ________________________________________

Date of arrival (If not born in Kenya) ________________________________________________________________
14. Name and address of Employer/Business _____________________________________________________________
15. Are you self employed? _________________please enter your Company details in item 14 above.
16. Your Position at work ____________________________________________________________________________
17. Do you have any criminal record in Kenya or anywhere else in the world? YES/NO if YES and you were convicted,
please give details.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

18. Which Sporting or recreational facilities of the Club do you intend to use? Please write them down in order of your
preference.

_____________________________/____________________________________/____________________________

_____________________________/____________________________________/____________________________

19. If you have any sporting talents give details below including your achievements in any major tournament:______________________________________________________________________________________________
______________________________________________________________________________________________

20. Would you be prepared to provide honorary service in the interest of the Club in your spare time when called upon to
do so by the Club Committee? Please give your comments below:-

YES/NO_______________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

21. I Have read and understood the conditions of my being accepted as a member of this Club and the Basic Club ByeLaws which appear on the last page of this Application Form and I agree to abide by them and those rules which
shall be in force from time to time. I confirm that all the information given by me in this form is true.
Signed ___________________________________________________________Date__________________________

22. We, the Proposer and the Seconder named herebelow confirm that we have no outstanding Amounts due to the Club
as at the date of this application.

Proposer __________________________________

Membership Number____________________________

23. I have known the applicant for ________________years

I have Proposed/Seconded ONE

TWO

applicants this Calendar Year.

Proposers date joined __________________________________ Signature ________________________________

Seconder ________________________________________ Membership Number ____________________________

I have known the applicant for ________________years

I have Proposed/Seconded ONE

TWO

applicants this Calendar Year.

Seconders date joined ________________________________ Signature ___________________________________

Membership Fees

I wish to become a _________________________________________

For Official use only

Basic Membership Rules

1. Proposer and Seconder must themselves be members for at least five (5) years standing.

2. Once mentioned names of applicants will be exhibited on the Club notice board for three months during this period
the applicant may use the Clubs facilities as a restricted member.

3. During the period of restricted membership, the Proposers and Seconders will ensure that applicants are introduced to
at least (6) Directors of the Board of Directors.

4. During the period of restricted membership proposers and Seconders are responsible for the debts and behavior of
their candidate.

5.

Restricted members must not introduce guests to the Club.

6. Full members can only Propose or Second up to 2 (two) applicants a year.

7. Guests not exceeding three in number at any one time may be introduced by full members. A guest may not be
introduced to the Club on more that two occasions a month.

8. Members must produce their membership cards whenever requested to do by a member of the Board, Club Manager
or the security staff.

9. Members accounts are payable within 28 days of the ensuring month.

10. If a members account remain outstanding for more than 28 days, a 5% service charge will be imposed automatically.
Members with accounts outstanding beyond 42 days will be liable for suspension and subsequent posting.

NB. Members are advised to acquaint themselves with the constitution and Club Bye-laws, copies of which may be
obtained from the office.