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.
(Please complete for all members of the household over 18 years of age)
Lot No .. Street No . Water Line No. ..
Phone No Mobile No
Postal Address . .
Signature of Applicant/s ...
Receipt: .. Annual Subscription: $20.00 incl. GST