08 3rd, 2016 admin

Membership Form

NORTHERN  SUBURBS  COUNTRY  MUSIC  CLUB Inc

MEMBERSHIP / RENEWAL FORM

Member No.  ………………

NAME/S   …………………………………………………………………………

……………………………………………………………………………………………

ADDRESS  ………………………………………………………………………..

……………………………………………………………………………………………

PHONE  ………………………….. MOBILE  ……………………………….

EMAIL ……………………………………………………………………………….

¨Tick if you would like to receive the newsletters by email

Membership Types    ( circle membership type)

Single    $15   Couple    $20   Family   $ 25    Student/Child  $2

Pensioner /Concession  $ 8   Pensioner/Concession Couple  $15

 

Birthday(Day & Month only)

Name ………………………………………….Birthday…………………………..

Name …………………………………………..Birthday………………………….

I/We agree to abide by the Constitution, By Laws and Code of Conduct Northern Suburbs Country Music Club Inc.

Signature/s ……………………………………………..Date ………………………….

 

Proposed By …………………………..Seconded By  ……………………………..

(For new members only)



 

NSCMC

Bald Hills Memorial Hall
2126 Gympie Road
Bald Hills

Enquiries:
Jim Dionysius
p: 07 - 3205 4233
e: info@nscmc.com.au

Archives