Application for Membership/Renewal

Meredith Community Centre Incorporated A0018310T

I, the person named desire to become a member of the above named Association. In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being enforced.

First Name *

Last Name *

Street Address *

Address Line 2

City *

Post Code *

Phone Number

Mobile Phone Number

Email Address

Signed *

clear

Date * +

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Membership ($5.00)

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