Application to Join

The Avicultural Society of
Tasmania Inc.

(Please Print)
 
First Name..........................................................
 
Surname.............................................................
 
Address.............................................................
 
....................................................................
 
State.............................................Postcode .........
 
Phone .......... ..................................
 
If this is a family Membership state given names below.
 
......................./......................../......................
 
......................./......................../......................
 
Please list Birds that you are interested in
 
....................................................................
 
....................................................................
 
Signature......................................Date...../..../.........
 
Subscription Rates,
Single/Family......$30.00
Pensioner/Family...$25.00        Pension No.  ..........................
Junior under 14yrs)$12.00
 
Please fill in this application and send it WITH PAYMENT to,
 
The Membership Officer
Avicultural Society of Tasmania inc.
PO.Box 714 
Moonah
TAS  7009 
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       Proposed By.....................................................
 
       Presented to Committee meeting....../....../..........
 
       Signed by............................................President 

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