 |
|||||||||||||||||||||
 |
|
 |
|||||||||||||||||||
 |
|||||||||||||||||||||
|
Australian Spiritualist Union PO BOX 273, PENRITH. ABN: 74.875.781.278. Phone: 1300.880.675 Email: asuofctreasurer@gmail.com MEMBERSHIP/APPLICATION FORM Annual Renewal Individual Insurance Individual No.
... Concession Group New Application Group Previous Member A copy of Concession Card is required if applying for Concession Membership DETAILS: INDIVIDUAL MEMBER OR LEADER OF CHURCH, CENTRE OR GROUP Members First Family Title
Name
........ Name.............................
. Home
. Home Address:
.. Phone:...............................
.... Town/Suburb:
Home Fax:..........................
... State:
... Postcode:
.. Mobile:...............................
. Email:
... Mail
.. Address:
. DETAIL CHURCH, CENTRE, GROUP OR BUSINESS NAME Group Name:
... Venue Address:
.. Town/suburb:
.State:
Postcode:................
.. Frequency of meetings:
...................................... Your Services: (or abilities): Yes No Office use only 1. Do you provide Church Platform Work /Proof of survival...................... date rec 3. Do you provide Psychometry/Clairvoyance................
... M/C ok 4. Do you provide Healing/Counselling/Advisory services
Certif issue 5. Do you provide Natural Therapies/Complementary Medicine
Card issue 6. Do you provide Products manufactured or delivered ............. Renewal of MEMBERSHIP AND INSURANCE is due 1st March each year. Group/Business details are public. Personal details are kept in accordance with the Privacy Act. We/I agree to uphold and abide by the ASU of Churches conditions of membership and the Code of Conduct. Date
.. Signature
|
 |
 |
|
| Site Map |