SCOTLAND ISLAND RESIDENTS ASSOCIATION
P O Box 70, Church Point. 2105
ABN 19 163 341 913
APPLICATION FOR MEMBERSHIP
Incorporated under the Associations Incorporation Act 1984
MEMBERSHIP YEAR 2006 / 2007
Ending June 30, 2007
I/We the undersigned hereby apply for membership of the Scotland Island Residents
Association Incorporated and agree to be bound by the Rules of the Association.
I/We .
. .
(Please complete for all members of the household over 18 years of age)
Lot No .. Street No . Water Line No. ..
Phone No Mobile No
Email Address
Street Address
Postal Address . .
Signature of Applicant/s ...
...
Date
Receipt: .. Annual Subscription: $20.00 incl. GST