THE SWEDISH CLUB

P.O.BOX H92,  AUSTRALIA SQUARE

SYDNEY NSW 2000

  APPLICATION FOR MEMBERSHIP OF THE SWEDISH CLUB

Open as Word Document

Please complete the details below in print, sign and return to The Swedish Club at the above address, together with your cheque, money order, or alternatively fill out the creditcard form. (Please do not send cash and please print all but your signature).

  SURNAME:                           ...............................................................................................

CHRISTIAN NAME/S            ................................................................................................

COUNTRY OF BIRTH.......................NATIONALITY.............................

HOME ADDRESS:

 ................................................................................................

POST CODE..................................

TELEPHONE NUMBERS:

HOME.............................BUSINESS......................................

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

BUSINESS NAME/TYPE OF BUSINESS ........................................

ENCLOSED PLEASE FIND MY CHEQUE (M/ ORDER)      

$................COVERING

  ..................JOINING FEE                                         $    5.00

  ..................MEMBERSHIP FEE                               $  30.00*

  ...................DONATION                                               $  .........

 

APPLICANTS SIGNATURE:                                  PROPOSED BY:

.....................................................                                           .....................................................

*MEMBERS JOINING IN THE SECOND HALF OF THE YEAR ONLY PAY $15.00.

 

CREDITCARD:                     BANKCARD / MASTERCARD / VISA

CARD NUMBER………/……………/……………/……………EXP………./……….

NAME ON CARD……………………………………………………..

SIGNATORY…………………………………………………………..