American Civil War Round Table of Australia New South Wales Chapter (an incorporated association)

Email: ..... Website: www.americancivilwar.asn.au
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Membership Application Form

To: Secretary, American Civil War Round Table of Australia (NSW Chapter), PO Box is 199, Campsie NSW 2194

I hereby apply to become a member of the American Civil War Round Table of Australia (NSW Chapter) Inc. (NSW Incorporated association number: INC 9882123)

For Members Register:

Name _____________________________________________________ Occupation __________________________

Address ___________________________________________ Suburb/Town __________________ Postcode: ______

Other contact information:

Phone ( __ ) _______________ Mobile: _______________ Email: _____________________@___________________

Skype name: __________________ Facebook Messenger: ________________________ Other: __________________

Please print carefully

In the event of my admission as a member, I agree to be bound by the rules of the association for the time being in force:

Signed: ____________________________ Date _______________ 20___

I live in the Sydney metropolitan area and paid by EFT to BSB: 082 445 Ac: 413569756 (Date: ___ / ___ / 20___ )
OR enclose a cheque for $45* payable to ACWRTA (NSW Chapter).
* The membership fee for those living outside the metropolitan area is $40.00

I _____________________________________ a member of the association, nominate the applicant, who is personally known to me, for membership of the association.

Proposer to sign: _________________________ Date _______________

I ____________________________________ a member of the association, second the nomiation of the applicant, who is personally known to me, for membership of the association.

Seconder to sign: _________________________ Date _______________