P.O. Box 416 – INALA – QLD 4077FRENCH AUSTRALIAN ASSOCIATION
OF QUEENSLAND (Inc.)
P.O. Box 416 – INALA – QLD 4077
APPLICATION FOR MEMBERSHIP
Year 2008
Names and surnames in block letters please
Mrs_________________________________________________________________
Miss_________________________________________________________________
Address______________________________________________________________
Suburb __________________________ Post code __________________
Phone :________________ Fax : _____________ email : ___________________
Nationality __________________________Occupation_________________________
Would you like to receive the newsletter by e-mail? Yes p No p
Names and dates of birth of children if under 12 year old
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Hereby make application for membership of French Australian Association of QLD (Inc.) and enclose:
Ø $20 per family (annual fee) - $15 per single (annual fee)
Business card advertising member $40 (Annual fee)
This application is nominated by: _______________Date_________ Signature___________
Date________________ Applicant Signature ______________________
S'il vous plait. Imprimer ce formulaire, remplir et envoyer à l’adresse ci-dessus avec le montant de la cotisation, merci.
Please print clearly, and mail it with membership fee to the address above.
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