MEMBERSHIP APPLICATION
NOTICE TO ALL MEMBERS
SUBS ARE DUE ON JANUARY 1ST EACH YEAR AND ARE PAYABLE
TO
BASSENDEAN HISTORICAL SOCIETY (INC)
P.O. BOX 361
BASSENDEAN WA 6934
To the Treasurer,
I..........................................................................................................................................................
of........................................................................................................................................................
hereby apply for membership in the BASSENDEAN HISTORICAL SOCIETY (INC) and enclose an annual subscription for the year ending 31st December 2004 comprising:
$5 per person
Date....................................................................................................................................................
Signature..............................................................................................................................................
For further information please phone the Treasurer on: (08) 9279 7713
or the Secretary on (08) 9279 1715.
