GOLDFIELDS LAND AND SEA COUNCIL Aboriginal Corporation (Representative Body) ABN 54 489 243 524 ICN: 364
14 Throssell Street, Kalgoorlie WA 6430 PO Box 10006, Kalgoorlie WA 6433 Telephone: (08) 9091 1661 Fax: (08) 9091 1662 Website: www.glc.com.au
APPLICATION FOR MEMBERSHIP I hereby apply to be a Member of the Goldfields Land and Sea Council Aboriginal Corporation. I agree to be bound by the Rules of the Association. (Surname – BLOCK LETTERS):
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(Christian Names – BLOCK LETTERS): …………………………………………………………………... (Date of Birth): (Address):
Reason for Non Approval: …………………………………………………………………………………………………………….. …………………………………………………………………………………………………………….. …………………………………………………………………………………………………………….. Entered in Membership Register by: …………………..………………..………………. Application Form/Updated April 2011/mw
Application for GLSC Membership Form - Updated April 2011.pdf ...
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opportunities overseas or, where required, to enable the IET to meet any legal or other legitimate obligations in that country. IET products and services are ...
Home Country/State: Undergrad ... Musical Director and the committee, and that failure to pass an audition will result in the termination of membership. Should.
Zip. Home Phone: Mobile Phone: Email Address: Past Address: House #. Street Name. City,. State. Zip. DoB: Age: US Citizen: â¡YES â¡NO. (Non-US Citizens must provide proof of authorization to work in the US). SS#:. Drivers License #:. MEMBERSHIP CLA
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invention (PTI) program or entered into a plea bargain agreement in connection ... I understand that by affixing my signature to this page I hereby agree to and ... Background Investigation check of myself as an applicant for membership in the.
Membership of âDwarka Forumâ. I/We hereby confirm that I/We am/are the bona-fide Resident / Regd. Body of Dwarka Sub-city, New Delhi and also I/We am/are regularly residing in the above mentioned address with my family members. Contact Details: P
By signing this application, I authorize the Association, (including local, state and national) or their subsidiaries or representatives to fax, e-mail, telephone or ...
original application to the International Executive Office of the Fraternity within ten days of the initiation ... Permanent Phone Number ... Executive Office Use Only.
Membership Application 2016-2017. Return this form to any Executive Board Member It's never too late to join! Membership Fee- $26. PLEASE PRINT CLEARLY. NAME: ...
MEMBERSHIP APPLICATION. PERSONAL INFORMATION. Name: Institutional affiliation and position (if any):. Address: Eâmail address: We will never pass personal information (incl. contact details) on to third parties. MEMBERSHIP PACKAGE. Please tick appr
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