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Expressions of Interest or Assistance with Huts Activities
Application for Membership
Download the 2009 -2010 membership form as a pdf for printing
APPLICATION FOR MEMBERSHIP OF
The Victorian High Country Huts Association
Incorporated
Registered Number A0043804Y
(a) Ordinary Membership $35.00 annually
I, .............................................................................. (name),
of............................................................................................................
................................................................................................................(address)
Post code...............................
Phone: ........................................... Fax: ................................ Email: ...................................
desire to become an ordinary member of The Victorian High Country
Huts Association Incorporated
I wish to receive notices, communications etc by post/facsimile/email
(delete as appropriate)
(Optional) I wish to include my spouse .............................................................(name)
and dependent children under the age of 18 years .............................................................
..........................................................................................................(names)
in my membership. I understand that this membership entitles me to one vote at general meetings of the Association.
In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force.
....................................................Signature of Applicant
..............................................Date
(b) Corporate Membership (Club, Society, Business etc) $60.00 annually
I, ................................................................................. (name),
being the ......................................................... (official position) of
.......................................................................... (name of organisation)
with contact address of ............................................................................................................
................................................................................................................... (address)
Post code.........................
Phone: ..................................... Fax: ................................. Email: ........................................
wish to apply for Corporate membership of the Victorian High
Country Huts Association Incorporated.
We wish to receive notices, communications etc by post/facsimile/email
(delete as appropriate).
I wish to nominate the following person to vote on behalf of our organisation at future general meetings:
.................................................................... (name).
We understand that we may appoint a proxy for all meetings in the
usual way.
In the event of our admission as a member, we agree to be bound by the
rules of the Association for the time being in force.
...................................................................................Signature of Applicant
................................................. Date
Please print out, fill in and return WHOLE FORM to:
VHCHA Membership Subscriptions, PO Box 216, Blackburn, Vic 3130
Ordinary Membership fee, annually ....... $35.00........................$
Corporate Membership fee, annually .... $60.00........................$
Donation to VHCHA ...............................>>...............................................................$
TOTAL $................
Payment Details: Cheque / Money Order Payable to Victorian High
Country Huts Association Inc
or Credit Card: Visa / MasterCard
Name on Card: ................................................................................
Card Number: ........................................ Expiry Date: ........................................
Signature of Cardholder: ................................................................................