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Last Name

Full Name

Subject

WPNA Application

Preferred Name

Gender

MaleFemaleGender Neutral

Identity Number

Email Address

Occupation

Cell Phone Number

Marital status

—Please choose an option—marriedpartnershipsingledivorcedwidow

Next of Kin Name

Next of Kin Relationship

—Please choose an option—spousepartnermotherfatherbrothersisterauntniecenephewcousingrandfathergrandmotherfriendcolleagueneighbour

Next of Kin Phone Number

Home Address

Postal Address

How long have you been a naturist?

—Please choose an option—I am new at this1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years19 years20 years21 years22 years23 years24 years25 years26 years27 years28 years29 years30 years31 years32 years33 years34 years35 years36 years37 years38 years39 years40 years41 years42 years43 years44 years45 years46 years47 years48 years49 years50 years50+ years

Are you a member of any other naturist group?

—Please choose an option—YesNo

Why would you like to join the WPNA?

You will be contacted by a WPNA Management Committee member for an appointment for a meet-and-greet.

GENERAL NOTES

After the meet and greet, you will be notified if your application was successful. Once you have been accepted, WPNA will require a recognizable profile head and shoulders photo of yourself or you as a couple, without which a membership card cannot be issued. The above information and profile picture is for the use of the committee and your membership card, and will not appear on any WPNA promotional material, website or other naturist related documentation or media unless you give consent in writing. You will be required to pay a R330 per person annual membership fee as soon as your application is approved after which your membership card will be sent to you.

DECLARATION BY APPLICANT

By submitting this application form, I hereby declare that I have read and understood the constitution and the code of conduct of the WPNA. I undertake to conform to these regulations and understand that non-conformance could result in an investigation and possibly being blacklisted from the association. I further declare that all the information I have supplied are true and correct. I understand and agree that the decision regarding my application by the WPNA Management Committee is final.