Membership Application

CROCKANGO ANGLING CLUB AFFILIATED WITH RIVER ANGLING NAMIBIA

Please take note this form requires the following documents to uploaded, please have them ready before completing the from:

Copy of ID or passport for each member
Copy of a Valid Angling permit for each member or application on this form for a valid fishing permit
Copy of Recreational boat permit (boat owners only)
Boat Registration & Safety Equipment Check List (boat owners only)

WITHOUT THE ABOVE DOCUMENTS YOUR MEMBERSHIP WILL BE INCOMPLETE AND
CAN NOT BE APPROVED

APPLICATION FEES
Annual membership fees must be paid in full, cash or with direct bank deposit. Membership applies for January to December of current year. All approved members are affiliated with River Angling Namibia and automatically receives membership from RAN.

Main Member – N$550.00

Additional Member – N250.00 (additional member must be from the same household & a school going pupil or proof must be provided if student)

Junior Member – N$250.00 (if junior applies for main member)

Main Member Details

First Name *

Surname *

Cell No: *

Id / Passport Number: *

Email Address *

Vehicle Registration No:Vehicle Traveling to fishing Waters

Postal Address:

City *

Region

Main Member Age *Please select relevant age gap

Apply for Spouse as Additional Member? *YesNo

Number of Children *(if membership privileges are desired)

Copy of ID/Passport or Birth Certificate Document *

No file chosen

Copy of ID Document is Compulsery for Permit Application

Main Member Fishing Permit

Valid Fishing Permit for 12 Months is Complulsery for RAN Anglers

Upload or Apply for a Valid Fishing Permit for 1 Year? *Non-RAN Member (Campsite Only)Upload valid 12 Month PermitApply as Namibian for N$ 240Apply as Non-Namibian for N$ 480Valid Fishing Permit for 12 Months is Complulsery (No Exceptions)

Please Upload Main Member 1 Year Fishing Permit *

No file chosen

Valid Fishing Permit for 1 Year is Complulsery (No Exceptions)

Residential Address: *

Nationality *

Country *

Additional Members

Additional Member (Spouse)

First Name *

Surname *

Cell Number *

ID / Passport Number *

Email Address *

Upload or Apply for a Valid 1 Year Fishing Permit?(Spouse)Non - RAN Member (Campsite Only)Upload valid 12 Month PermitApply as Namibian for NS 240Apply as Non-Namibian for N$ 480Valid Fishing Permit for 12 Months is Complulsery (No Exceptions)

Please Upload Additional Member 1 Year Fishing Permit (Spouse) *

No file chosen

Valid Fishing Permit for 1 Year is Complulsery (No Exceptions)

Residential Address *

Postal Address *

Nationality *

Country *

Copy of ID / Passport Document *

No file chosen

Copy of ID Document is Compulsery for Permit Application

Child Member #1

First Name *

Surname *

Cell Number

ID / Passport / Birth Certificate Number *

Email Address

Date of Birth *

Day

Month

Year

Upload or Apply for a Valid 1 Year Fishing Permit? * (Child Member#1) *UploadApplyValid Fishing Permit for 12 Months is Complulsery (No Exceptions)

Please Upload Child #1 Fishing Permit for 1 Year *

No file chosen

Please upload valid Fishing Permit for Additional Member here.

Residential Address *

Postal Address *

Nationality *

Country *

Copy of ID/Passport or Birth Certificate Document *

No file chosen

Copy of ID Document is Compulsery for Permit Application

Child Member #2

First Name *

Surname *

Cell Number

ID / Passport / Birth Certificate Number *

Email Address

Date of Birth *

Day

Month

Year

Upload or Apply for a Valid 1 Year Fishing Permit? * (Child Member#2) *UploadApplyValid Fishing Permit for 12 Months is Complulsery (No Exceptions)

Please Upload Child #2 Fishing Permit for 1 Year *

No file chosen

Please upload valid Fishing Permit for Additional Member here.

Residential Address *

Postal Address *

Nationality *

Country *

Copy of ID/Passport or Birth Certificate Document *

No file chosen

Copy of ID Document is Compulsery for Permit Application

Child Member #3

First Name *

Surname *

Cell Number

ID / Passport / Birth Certificate Number *

Email Address

Date of Birth *

Day

Month

Year

Upload or Apply for a Valid 1 Year Fishing Permit? * (Child Member#3) *UploadApplyValid Fishing Permit for 12 Months is Complulsery (No Exceptions)

Please Upload Child #3 Fishing Permit for 1 Year *

No file chosen

Please upload valid Fishing Permit for Additional Member here.

Residential Address *

Postal Address *

Nationality *

Country *

Copy of ID/Passport or Birth Certificate Document *

No file chosen

Copy of ID Document is Compulsery for Permit Application

Boat Registration

Upload or Apply for a Valid 1 Year Boat Fishing Permit? *Upload a Valid 12 Month permitApply for N$ 60Do not own a BoatValid Boat Permit for 1 Year is Complulsery (No Exceptions)

Upload Valid 1 Year Boat Fishing Permit *

No file chosen

Valid Boat Fishing Permit for 1 Year is Complulsery (No Exceptions)

Membership Fees

Forecasted Membership fees

Please note these fees are only forecasted and will be confirmed by Crockango

Forecasted Permit Fees

Please note these fees are only forecasted and will be confirmed by Crockango

Total Amount to be Paid

Annual membership fees must be paid in full, cash or with direct bank deposit

BANKING DETAILS

Total Amount to be paid: {calculation-3}
to
Crockango Angling Club
Bank Windhoek, Rundu
Branch Code: 483-173
Acc No: 1211494501 (Cheque)

Upload Proof of Payment

No file chosen

CROCKANGO ANGLING CLUB AFFILIATED WITH RIVER ANGLING NAMIBIA