International
Plastic
Modellers
Society
NSW Branch
PO BOX 775, WEST RYDE NSW 1685 AUSTRALIA
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OFFICE USE ONLY
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MEMBER NO_____________ |
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RECEIPT NO_____________ |
Please print using your browsers print function, then close this window
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International |
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MEMBERSHIP APPLICATION |
PLEASE PRINT CLEARLY
SURNAME: __________________________________ GIVEN
NAMES: _________________________________
ADDRESS:____________________________________________________________________________________
STATE: ___________________________POSTCODE:_______________ DATE OF
BIRTH:__________________
TELEPHONE
(HOME):___________________________ (WORK):_______________________________________
EMAIL:_______________________________________________________________________________________
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Please add my email address to the official club mailing list (used for official club email only) |
OCCUPATION:________________________________________________________________________________
MODELLING
INTERESTS:_______________________________________________________________________
_____________________________________________________________________________________________
HOW LONG
HAVE YOU BEEN BUILDING PLASTIC MODELS?________________________________________
DO YOU
BELONG TO ANY OTHER MODELLING CLUB?_____________________________________________
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$30
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ADULT MEMBERSHIP |
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$15
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SENIOR MEMBERSHIP (Seniors Card Required) |
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$15
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JUNIOR MEMBERSHIP (< 18 yrs) |
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$25 |
MAGAZINE ONLY (supplied electronically on CD) |
ENCLOSED
IS A CHEQUE/MONEY ORDER FOR (AUD) $_____________________________________________
MADE PAYABLE TO : IPMS
NSW
SIGNATURE:___________________________________________________________
DATE:_________________
MAIL TO: THE MEMBERSHIP SECRETARY, IPMS NSW, PO BOX 775, WEST RYDE, NSW 1685, AUSTRALIA