Warragul Poultry Club Inc

Subtitle

Standard Classes

The Standard Exhibiton classes can be found at Psbev.com.au

Joining

WARRAGUL POULTRY CLUB INC

                                            

Date: …../..…/201...

 Doc update: 11/13

 

Membership Application & Information

Please fill in the following if applying for membership or to update your membership information.

This information is for communication purposes from the committee to members and other than a list of membership names, will not be made public unless individual members give their consent.

Surname ………………………………………………..       Given Name ………………………………………

Names of any other family included in this membership ………………………………………………………………………………

New member                 Renewing Membership                   I Have been a member for                    years

Membership Fee:      Single:  $10.00                Joint family: $15.00                      Junior (under 16):  $2.00             

Address: ……………………………………………………………… Town ……………………………………. Post Code ………….

Phone No: ………………………                                    Mobile:  ……………………………………………

Email:   ………………………………………………………………………………………………………….

  Breeds Kept;    Standard                         Bantam

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please circle the following  if you wish to have the information available to club members seeking to buy birds, eggs or asking for help:

I am willing to be contacted about birds/eggs I may have for sale              Yes  / No                     

I am willing to have my phone/mobile no given                                                       Yes   / No   

I am happy to have my address given                                                                           Yes / No                              

Please return this form with your membership fee to a committee member or send to:

Treasurer:                             Jim Lewis 

                                           Warraview Dve

Warragul 3820                        [email protected]                                                                                                   

 An annual membership fee of                       is enclosed with this information.

                                Signature of primary applicant  …………………………………………..                                                          

 

Mail form to; Ken Bjorksten Phillips Rd Heath Hill 3981