3 TRANSPORT ASSOCIATION

Membership Application

To:

The Secretary/ Treasurer
3 Transport Association
3 Orion Close
PORT MACQUARIE NSW 2444

Surname:_____________________ Given Names ___________________________

Address: ____________________________________________________________

__________________________________________________________PC ______

Ph: ( __) _____________________ Work: ( __)______________________

Fax: (__) ____________________ Mobile (__) ______________________

Email Address: _________________________________

I would like to become a member of the 3 Transport Association. If my applicaiton is successful I agree to be bound by the rules of the association while I remain a member.

Under the Privacy Act 1988, I consent to the disclosure of my personal pariculars given above to other members of the 3 Transport Association.

Signature of Applicant ________________________ Date: _______________

Joining Fee:
One off

$10

Subscription
1Jul - 30 Jun
$10
My Donation:
$ ____ 
RACT Dress Tie
$30
RAASC Pocket
$35
RACT Pocket
$35
Total
$_____

All Cheques to be made payable to the 3 Transport Association Inc.