AUSTRALIAN ARIEL REGISTER Inc. (A0030096D)

APPLICATION FOR MEMBERSHIP 2008

Please enroll me as a member of the Australian Ariel Register for the year 2008.  I understand that the information supplied on this form will be treated as confidential.

 Please use block letters.

FULL NAME.................................................

PREFERRED NAME (for introduction)...................................................

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

STATE.............................POSTCODE...................

TELEPHONE: home ...................................work-if convenient...............................

Email............................

I enclose my cheque or money order for $30 as my joining fee ($10) and subscription ($20) for the year 2008 (membership renewals fall due on 1st. January each year and are for a calendar year)

DATE............................           SIGNATURE...........................................

MACHINE REGISTER DETAILS. This information is useful for our records and may help you and others. ATTACH SHEET FOR ADDITIONAL MACHINES.

Please return this form, with your subscription fee to:  COLIN HILL, SECRETARY, AUSTRALIAN ARIEL REGISTER, 180 KOSCIUSZKO AVE, PALMERSTON, ACT 2913  

MAKE YOUR CHEQUES PAYABLE TO THE AUSTRALIAN ARIEL REGISTER

NB: The membership year runs from 1 January . Applications received after 1 October 2008 will be credited to the following year.

OFFICE USE –

Membership No....................... Receipt No.......................... Entered Computer.................

Badge sent.......................                   Journal sent..................        Card sent.......................     (form updated 22/04/08)   6/00