AucklandSoar Inc.
Please complete all details Clearly
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NAME:
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ADDRESS:
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PHONE: (hm)
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(wk)
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(mob)
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EMAIL:
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DATE
OF BIRTH:
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OCCUPATION:
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NZMAA
No:
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FREQUENCIES USED:
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MEMBERSHIP TYPE:
Please Circle
Senior
$30
Junior
$20
Family
$40
Associate
(Newsletter only) $30
NZMAA
AFFILIATION:
Senior
$55
Junior
$20
Family
$62
None
(affiliated through another club)
$0
TOTAL AMOUNT:
$___________
Cheques
should be made payable to : AucklandSoar
Inc.
Please
return completed forms with payment to :
Ted
Bealing
36 Ripon Crescent
Meadowbank
Auckland
PERSONAL INFORMATION
PRIVACY ACT 1993 - In
accordance with the Privacy Act 1993; I authorise AucklandSoar to use
such
personal information as listed on the membership form for the purpose of
planning and promoting AucklandSoar activities,
communicating
information to me concerning my membership responsibilities and/or listed
interests, publishing competition results,
mailing
of the Club's Official Publication, providing general statistical information
to approved organisations and any other lawful
purpose
relating to membership of AucklandSoar.
____________________________________________________________________________________
Signed
Date