APPLICATION FOR MEMBERSHIP

The Braidwood & District Historical Society Inc.
186 Wallace Street, PO Box 145, NSW 2622
Telephone (02) 48422310
Email antony.davies@millpond.com.au

Name _______________________________________________________________________________
Address ____________________________________________________________________________
_________________________________________________________________________________
Phone __________________ E-mail ______________________
Subscription Fee $15 per person or $25 per family.
Paid Cash_______or Cheque______
I HEREBY APPLY TO BECOME A MEMBER OF THE BRAIDWOOD AND DISTRICT HISTORICAL SOCIETY INC. I AGREE TO BE BOUND BY THE RULES OF THE SOCIETY.
______________________________________________________________________________________Date                         Signature of Applicant
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OFFICE USE ONLY
Committee Meeting Acceptance Date_____________________________________________________
1. New Members' Letter - Action Date
2. Enter Members' Card Register -  Action Date
3. Computer Membership Listing - Action Date
4. Subscription to treasurer paid cash or cheque Postal or Desk


NB! This form to be lodged at the next committee meeting. If this form is lodged at the reception, Volunteer please place in office manager's folder, enter subscription money on the day sheet & put it in the till