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					                                                               P.O. Box 395, Malvern,
                                                               Victoria, Australia 3144
                                                               Phone: 61 (3) 95276575 or (3) 98486626


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                                     Guild Australia Inc.
Membership Application Form
July 1, 2009 – June 30, 2010

ANNUAL FEE                                      PRO RATA:

1 July 2009 – 30 June 2010                      1 Jan – 30 June
$40.00 Single Membership                        $20.00 Single Membership

                                                    (Applies to new members only)


All Membership fees are in Australian Dollars
OVERSEAS Members (outside Australia) AUD $60.00 per annum

MEMBER DETAILS


Mr/Mrs/Miss/Ms ____________________________________________________________
                             Given Name                  Family Name



Address ___________________________________________________________________


Suburb _______________________________ State _____________ Postcode ________


Country ___________________________________________________________________


Telephone ___________________________________ Fax ________________________



E-Mail ____________________________________________________________________



Signature __________________________________________________________________

				
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