The Somerville, Tyabb and District Heritage Society Inc.
P.O. Box 363, Somerville, Victoria. 3912
MEMBERSHIP APPLICATION
I,
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Of
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Phone ...…………………………...
Desire to become a member of The Somerville, Tyabb and District Heritage Society Inc.
In the event of my admission as a member, I agree to be bound by the rules of the Society in
force for the time being.
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Signature of Applicant
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Date
I, …………………………………………………….. a member of the Somerville, Tyabb
and District Heritage Society Inc. nominate the Applicant, who is personally known to me,
for membership of the society.
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Signature of Proposer
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Date
I, …………………………………………………….. a member of the Somerville, Tyabb
and District Heritage Society Inc. second the nomination of the Applicant, who is personally
known to me, for membership of the society.
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Signature of Seconder
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Date
The decision of the Committee on the Application of Membership will be made in writing
to the address of the Applicant above.
All persons signing this form agree to abide by the decision of the Committee.
No further correspondence will be entered into on the result.
Date Accepted into the Society
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Date Fees Paid
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