APPLICATION FOR MEMBERSHIP

Radio Yesteryear Inc.

ABN: 69 714 068 686

 

I …………………………………………………………………………. (full name of applicant)

 

of ……………………………………………………………………….. (full address & post code)

 

……………………………………………………………………………………………………….

 

Phone No: ……………………………………………………..

 

Email Address:  …………………………………………….…………………

 

Hereby apply to become a member of the above named Association.  If accepted, I agree to be

bound by the Rules of the Association for the time in force.

 

Signed ………………………………………………………… Date ……………………………..

 

Type of Membership Subscription applied for:                        

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  Full Membership  ……………. $5.00 per year        

 

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  Group Association ………….  $10.00 per year

 

 

Text Box:    Donation .. $5.00 .. $10.00 .. $20.00 or Amount  .. ($                  )

 

                                                                                                                  Total payable           ……………...

Please enclose a cheque or money order made out to:  Radio Yesteryear Inc.

 

 

Are you willing to assist Radio Yesteryear by offering your assistance?

 

 Presenter                                                       Admin/telephone staff

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Text Box:    Fundraiser                                                    Other (please contact RYY)

 

 

All information given is for the station use only and will be treated with the strictest confidence,

no information will be forwarded to a third party.

 

 

For Office use only:  Membership No:

 

Membership Paid (   )    Membership No Issued (   )   Membership Card Issued (   )

 

Postal Address: PO Box 3270 VALENTINE NSW 2280

Studio Phone No: 0243 405355

Office Phone No: 0428 366558

Email: radioyesteryear@integritynet.com.au