Transcript Slide 1
MEMBERSHIP Individual Membership (18 to 64 years) Honorary members (65 years +) (For full voting rights) $20.00 per person No charge Financial Year is from 1st July 2012 to 30th June 2013 I, ……………………………………………………………………………………………………… (NAME IN FULL) of,…………………………………………………………………………………………………….. (ADDRESS) (POSTCODE) hereby apply to be accepted as a member of the Kastellorizian Association of Victoria and promise, if accepted, to abide by the rules and articles of the Association. Date of Birth: … /… /…………… Place of birth:…………………………………………….. Occupation: …………………………………………………………. Married/Single (Circle) Telephone Nos. ………………………………………….Mobile ……………………………… . Email: ………………………………………………………………………………………………. Father’s name: ……………………………………. Place of Birth: ……………………………. Mother’s Name: …………………………………… Place of Birth: ……………………………… If parents were not born in Kastellorizo, please record your Kastellorizian connection : ………………………………………………………………………………………………………... Dated this……………………………………….. day of………………………………… 2012 Signature of Applicant: ……………………………………………………………………………… Note: If membership renewal please ignore the section below. Nominated by: ……………………………………………………………………….………………. Address: ………………………………………………………………………………………………. Date of Application…………………………… Date of Acceptance: ……………………….. ….. Secretary: …………………………………………………………………………………………….. PAYMENT OPTIONS 1. 2. 3. Mail Kastellorizian Association of Victoria Inc. PO. Box 112 South Melbourne Vic 3205 EFT transaction at your Bank, Post Office or Internet. BSB: 063014 Account No. 10118932 Credit Card Download forms from www.kastellorizo.com.au OFFICE USE ONLY –Receipt No.