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| Title |
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| Name |
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| Membership Number |
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| Residential Address |
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| State |
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| Postcode |
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| Postal Address (leave blank if same as above) |
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| State |
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| Postcode |
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| Birthday |
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| Home Phone |
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| Mobile Phone |
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| Email |
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| Receive Promotion Mail-outs |
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| Receive Annual Report |
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| Questionaire |
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| How often do you visit us? |
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| Do you like our new website and did you find it useful? |
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| How do you rate our Food & Beverage offers? |
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| How do you enjoy our promotions? |
Outstanding. I register for every draw! |
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Good. But I don't come for all of them. |
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Average. I might come to some. |
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Poor. I've seen better promotions at other clubs. |
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Aweful. Prizes are no good nor are the chances of winning. |
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| As a member what prizes would you prefer to win? |
Cash all the way! |
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Mixture of cash and other prizes |
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Electrical goods |
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Petrol vouchers |
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Cars |
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Other - Please Specify |
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