APPLICATION FOR MEMBERSHIP OF
WELLINGTON ARTS
Incorporated under the
Associations Incorporation Act 2009
PROFESSIONAL MEMBERSHIP
OF WELLINGTON ARTS
I, ____________________________________of ______________________________________
(Full Name of Applicant)
(Address )
_________________________________________________
_______________________
(Address )
(Phone)
___________________________________________________
(Email)
________________________________________
(Professional Arts Occupation)
Hereby apply to become a member of the above named incorporated association. In the event of
my admission as a member, I agree to be bound by the constitution of the association for the time
being in force.
____________________________________________________
(Signature of Applicant)
______________________
(Date )
I, _______________________________________
(Full Name)
a member if the association, nominate the applicant for membership of the association.
____________________________________________________
______________________
(Signature of Proposer)
(Date )
I, _______________________________________
(Full Name)
a member if the association, second the nomination of the applicant for membership of the
association.
____________________________________________________
(Signature of Seconder)
______________________
(Date )
............................................................................................................................................................
(Please detach with payment)
PAYMENT OF PROFESSIONAL MEMBERSHIP FEES
$50.00/pa
Name: ______________________________________
Payment: $____________________
Cheque / Cash / Direct Deposit
Direct Payment BSB: 082-922 Account: 73 384 0541
PO Box 42, Wellington NSW 2820
Phone: 02 6845 3005
Email: arts@wellington2820.org.au Fax: 02 6845 4009