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Please print this form out or save it, to print out later.
Important:- Before printing, use your browsers 'page set-up' and change each side to 1 cm. or 1/2 in. This will enable the form to fit on the paper.
Send it off to: 'Secretary (Mrs) Irene Hannan,
"Mountain View",
930 Caparra Road, Caparra, via Wingham, NSW 2429
OR: Take a copy and paste it into a word processor and email it to channan@tpgi.com.au
BELGIAN BANTAM CLUB OF AUSTRALIA APPLICATION FOR MEMBERSHIP
NAME (Mr / Mrs / Miss / Ms)
ADDRESS
................................................................................................................................................................
TELEPHONE / FAX NUMBERS
DATE OF BIRTH (OPTIONAL) .............................................
TELL US A BIT ABOUT YOURSELF (OPTIONAL)
............
............
............
WHAT TYPE AND COLOUR BELGIANS DO YOU HAVE?
OR WANT?
................................................................................................................................................................
WHAT OTHER BREEDS OF POULTRY DO YOU HAVE?...................................................
WHAT DO YOU FEEL THE CLUB CAN DO FOR YOU?...............................................................
MAY WE PUBLISH YOUR NAME (YES/NO), ADDRESS (YES/NO) AND TELEPHONE NUMBER (YES/NO)
EMAIL (YES/NO) IN THE CLUB
NEWSLETTER (YES/NO)
OR HAND OUT YOUR DETAILS IN ANSWER TO OTHER ENQUIRIES
(YES/NO).
ANY OTHER COMMENTS
THE MEMBERSHIP YEAR RUNS FROM THE
1st OF JULY
FULL MEMBERSHIP (single, couple, family, school or group) IS $15-00
JUNIOR MEMBERSHIP (up to and including 16 years) IS $7-00.
THESE PRICES ARE FOR MEMBERSHIP WITHIN AUSTRALIA ONLY
MAKE ALL CHEQUES PAYABLE TO
"THE BELGIAN BANTAM CLUB OF AUSTRALIA"
All prices quoted are in Australian dollars and
postage
rates are for within Australia only
Original
Web design, graphic art and manufacture by
Stephen Miller.
Said the first little chick, with a wiggle and a squirm,
I wish I had a nice fat worm. Said the second little chick, with a giggle and a squeal. I wish I had some fine yellow meal. Said the old
mother hen, from the green cabbage patch, If you really want it, then get out and scratch!
Please direct
enquiries to the
Secretary: (Mrs) Irene Hannan
"Mountain View",
930 Caparra Road,
Caparra, via Wingham, NSW 2429
Telephone: (02) 65507295
Email: channan@tpgi.com.au
The contents of these pages will always remain the property of the Belgian Bantam Club of Australia. The material may be used
for the purposes of private study, research, or to further pass on this information as
permitted under copyright legislation, but only if the source is fully credited at all times. No part may be reproduced or re-used for
any commercial purpose without the written permission of the Belgian Bantam Club of Australia. Further no modification to any of the information may be made without prior written consent.
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