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2010 Membership Application Form by bnWs0X


									                      2010 Membership Application Form
Name: (Mr / Ms / Miss)_______________________________________________

Monash Degree: ____________________________________________________
Campus: _______________________________ Year of Graduation: _________
Mobile: _______________________ Home: ___________________________
E-mail: ___________________________________________________________
Postal Address:_____________________________________________________

Type of Membership
□ Monash Graduate – Degree or Postgraduate-diploma Holders ……. HKD 160
□ Monash Current Student – Please submit copy of student ID card ..HKD 80
□ Associate Member – Non-Monash University graduate …….............HKD 170
* Please note that half-year membership is available. The half-year membership is valid from 1 July
 to 31 December and the fee is at the half price of above-mentioned.

Payment Method
Cash / Cheque $__________________        Cheque No. ____________________
By mail, please enclose your cheque made payable to:
“Monash University HK Alumni Association Limited”

Registered mail: Unit D, 17/F., Nathan Commercial Building, 430-436 Nathan
Road, Kowloon, Hong Kong.
Email: ; Website:

Signature: __________________________ Date: ________________________
Membership Card Received: ________________________ Date: _____________
* I agree that personal data provided in this application form may be used for marketing activities of
  Monash University HK Alumni Association Limited / Monash University.
MEMBERSHIP NO.: ________________ VALID TO: _31st Dec 2010 OFFICER: ______________

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