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The Foundation for National Renewal |
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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 or by fax to 07 5442 1587
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E-mail: constitution@national-renewal.org.au Last updated 2 May 2009 |