3MD RAASC/RACT ASSOCIATION MEMBERSHIP APPLICATION

Please return this form to: The Secretary
P.O. Box 484, Black Rock, Vic 3193.
The information given below will be used to establish a data base for members private use only.
Please indicate if you do not wish any information to be listed.

FAMILY NAME................................................GIVEN NAMES.................................................................................

ADDRESS......................................................................................................................................................................

STATE..................... P/CODE......................... 

PHONE    HOME....................................................  BUSINESS........................................................... 
MOBILE................................................................... EMAIL..................................................................

BUSINESS NAME........................................................................................................................................................

and Info..........................................................................................................................................................................

SERVICE INFORMATION

SERVING MEMBER         Y/N        RETURNED SERVICE MEMBER  Y/N   
EX SERVING MEMBER  Y/N

RANK HELD............................YEARS OF SERVICE......................................CORPS.............................................

UNITS SERVED WITH...............................................................................................................................................
(If insufficient space, please list over the page)

SOCIAL INTERESTS

GOLF                         Y/N          REUNIONS           Y/N           ANZAC MARCH           Y/N
DINNER DANCE     Y/N          AFTER MARCH  Y/N          BEAUMARIS MARCH  Y/N

OTHER SOCIAL EVENTS.........................................................................................................................................

A.  Joining Fee $6.00 (one time payment only for new members).  B.  Annual subs $6.00 per year.  C.  5 year subs $30.00
(does not include the join fee for new members).

SUBS DUE AS ABOVE                $...........................
CHEQUE ENCLOSED                  $..........................

Please mail to the Secretary at the above address.  Thank you.