EmailMeForm
2019/2020 Membership Upgrade application
1.
Direct Debit: Account Name: Swimming NSW Ltd.
BSB: 062-172
Account Number: 1028 3026
Description: Upgrade, ‘surname’
2.
Phone: Call our office on 02 9763 5833, to make payment with Credit Card, or provide your Name as it appears on the card, Card Number, Expiry Date and 3-digit number on the back of the card to mikaeli.cuell@nsw.swimming.org.au
3.
Send a cheque into:
Swimming New South Wales
PO Box 571
Sydney Markets NSW 2129
First name of Membership Upgrade applicant
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Surname of Membership Upgrade applicant
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Membership Number (if known)
Contact number
*
Email address
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Club
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Delivery Address for your upgrade inclusions
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Select the membership upgrade you wish to apply for. Note Swimmers can only apply for a "Swimmer" upgrade, and Non-Swimmers a "Non-Swimmer" upgrade.
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Platinum Non-Swimmer - $320
Platinum Swimmer - $320
Gold Non-Swimmer - $270
Gold Swimmer - $270
If a Platinum member or a Gold Swimmer, please select from the following options which colour(s) you would prefer for your Speedo Backpack:
Green, Red, Purple or Blue.
Preference 1 (List colour)
Preference 2 (List colour)
Preference 3 (List colour)
Which payment option will you proceed with (as per the instructions above)?
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Direct Debit
Phone payment / email Mikaeli
Cheque
I have not yet paid
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I confirm that I am a already a financial member of Swimming NSW for the 2019/20 season, and I have selected an upgrade package which corresponds with my existing membership type (e.g. Non-Swimmer selecting only a Non-Swimmer upgrade option).