Foundation for National Renewal| Foundation for National Renewal |
APPLICATION for MEMBERSHIP
NAME___________________________________
Phone ( )_________________
(
)_________________
Fax ( )_________________
POSTAL ADDRESS:
_____________________________________________
______________________________________________________________
______________________________________________________________
_______________________________
E-MAIL ADDRESS: ________________________________________
I hereby apply for membership of The Foundation for National Renewal and enclose payment of my annual subscription of $25.
Signed _______________________
Date___________
Cheques and/or Money Orders should be made payable to ‘The Foundation for National Renewal’.
It is not mandatory to provide the following information but it could assist the Foundation to achieve our aims.
EDUCATIONAL QUALIFICATIONS: __________________________________________________________________________________
OTHER SKILLS OR ATTRIBUTES THAT
COULD BE USEFUL TO THE ORGANISATION:
_________________________________________________________________________________
__________________________________________________________________________________
OCCUPATION(s)___________________________________________________________________
OTHER ORGANISATIONS to which you belong___________________________________________________________________
_______________________________________________________________
_____________________________________________________
The information provided on this form will be treated by the Foundation in the strictest confidence and will not be passed on to any other person or organisation without your express permission except as required by law.
Please print out this application and return to:
Memberships
The Foundation for National Renewal
PO Box 82
Woombye Qld 4559
or by fax to 07 5442 1587
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Last updated: 21 September 2007