Men of Central Australia need your support
Support us by becoming a financial member
Application for Membership
Name | _____________________________________________ | |
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Address | _____________________________________________ | |
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Phone | ______________________ | Fax__________________ |
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__________________________ |
I am applying to become a member of Men's Health Central Australia | |
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I agree to support the aims and objectives and be bound by the rules of the group | |
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I enclose $____________ for my 12 month membership |
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Signature:____________________ | Date:__/__/____ |
To apply for membership, print out this page, complete the details, attach your cheque or money order and mail to:
The Treasurer
Men's Health Central Australia
PO Box ????
Alice Springs NT 0870