RRDJ – Member Certification Form | Royal Registry de Jure

RRDJ Member Application - 3. RRDJ Member Certification

OFFICE USE FOR CERTIFICATION BY RRDJ

The following member has been interviewed and accepted by on the .

Please issue a membership no and initate the process of certification (button on the bottom).

RRDJ Membership No (digits only)

Member Details

Member's Absolute Title

Member's Abstract Name

Member's Phone

Member's Email

Passport Photo

Residential Address

Residential Address Line 1

Residential Address Line 2

Residential City / Suburb

Residential State

Residential Postcode

Residential Country

Postal Address

Postal Address Line 1

Postal Address Line 2

Postal City

Postal State

Postal Postcode

Postal Country

Proof of Payment

Membership Fee

AUD

Application Details

Date of Application

Full Age and Capacity

Signature of Member

Steward's details

Steward's name

Steward's RRDJ No

Steward's Email

Steward's Interview Confirmation

I, Steward can confirm that I identified the applicant

meeting at the following address:

Date and Time

meeting online using

Date and Time

Comments by the Steward

Confirmation of sound mind and capacity

Date of Acceptance

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