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Application - Vancouver Tsung Tsin _Hakka_ Association

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					                                             VANCOUVER TSUNG TSIN (HAKKA) ASSOCIATION
                                                  542 Keefer St, Vancouver, B.C. Canada V5A 1Y3
                                                     Telephone: (604) 251-5232 or (604) 251-0633
                                               Email: hakkabc542@gmail.com           Website: www.hakkabc.com

                                                MEMBERSHIP APPLICATION
                                                                                         Date:


                                 Applicant                                               Spouse (if applicable)
         Surname:                                                           Surname:
       First name:                                                         First name:
    English Name:                                                       English Name:

    Chinese name:                                    M/F               Chinese name:                                        M/F

              Birth: Year:                       Month:                         Birth: Year:                           Month:
                         City:                  Country:                                 City:                       Country:

                         Childen (Surname, given names)                                               M/F             Birth Yr       Birth Mn
           Child #1:
           Child #2:
           Child #3:
           Child #4:
           Child #5:
                                                                                                 Photo - member                    Photo - spouse
   Home address:
                 City:
                                                                                                     optional                         optional
         Province:                             Country:
      Postal Code:

            Home: (              )      -                                      Home: (           )       -
            Office: (            )      -                                      Office: (         )       -
              Cell: (            )      -                                        Cell: (         )       -
            email:                                                             email:
                         Member                                                          Spouse
Education level:
     Profession:
Business Name:
    Experience:

  Sponsored by:



         (Mandatory fields are highlighted; others are optional)                                             Applicant Signature
For Office Use
         Approval of Board of Directors:                                    Membership #:                           Spouse:


         Refer to minutes dated:                                              Annual Dues:


                                                                                 Receipt #:


         Completed by:                                             Membership type (R / A):

				
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posted:5/5/2011
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