APPLICATION FOR MEMBERSHIP

I/WE, _________________________________________________

WISH TO APPLY FOR ORDINARY/FAMILY/JUNIOR MEMBERSHIP OF THE TOODYAY FRIENDS OF THE RIVER (INC.). I/WE AGREE TO ABIDE BY THE CONSTITUTION AND BY-LAWS OF THE TOODYAY FRIENDS OF THE RIVER.

I/WE HEREBY TENDER $_______, BEING THE REQUIRED PAYMENT OF MY SUBSCRIPTION AS AN ORDINARY/FAMILY/JUNIOR MEMBER FOR THE PERIOD ENDING ____/____/_________

_____________________________________ DATE_____/_____/__________

(SIGNED
______________________________________________________________________________________________
(ADDRESS)
___________________________________________ ___________________________
(TOWN) (POST CODE)
___________________________________________ ____________________________________ _______________________________________
(HOME PHONE) (MOBILE) (EMAIL)

INTERESTS __________________________________________________________

(If posting this application, please address to: The Treasurer, Toodyay Friends of the River, Post Office Box 427, Toodyay 6566 and include the appropriate fee)

Fees for 2011-2012.(Inclusive of GST) Single Membership - $5.00, Family Membership $12.00, Junior Membership $3.00 Life Membership $50.00

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CLUB RECORDS ONLY
DONATION PAID $
DATE ACCEPTED ____/____/_______ (Meeting Date) FEES PAID TO ____/____/________

AMOUNT PAID $ ________	(incl GST $_______) MEMBERSHIP TYPE	ORDINARY/FAMILY/JUNIOR/LIFE
RECEIPT NO. ___________
	RECORDS UPDATED _____/_____/_________

ABN 84 891 011 078
email info@toodyayfor.org.au
www.toodyayfor.org.au