9RAR ASSOCIATION (QLD)
Member or
Supporter - APPLICATION
& RENEWAL Form
NEW MEMBER/NEW SUPPORTER or
RENEWAL
First Name: __________________________________
Name Required on Badge: _______________________
Address: ____________________________________
_________________________________________
_________________________________________
Telephone:
Home: (____) __________________
Work:
(____) __________________
Email: ______________________________________
Dates of service with
9RAR:___________to________
In which sub-unit (Coy/s) did you serve?
__________
Enclosed is a cheque for
(please circle):
$15.00 Ordinary Member (Fees are due 13 NOV annually)
$15.00
Assoc. Supporter (Fees are due
13 NOV annually)
$65.00
Fully Paid Up Member (ONCE ONLY PAYMENT)
============================================================
CHANGE OF ADDRESS
First Name ___________________________________
New Address: _________________________________
__________________________________
__________________________________
New Telephone: Home: (____) ___________________
Work: (____) ____________________
Date Change of Address Effective: _______________
New email: ________________________
PLEASE RETURN YOUR APPLICATION
OR
CHANGE OF ADDRESS TO THE ADDRESS BELOW
AS SOON AS POSSIBLE
9RAR ASSOCIATION (QLD)