Den Danske Forening - The Danish Club in Brisbane, Australia
Den Danske Forening - The Danish Club in Brisbane, Australia
Den Danske Forening - The Danish Club in Brisbane, Australia
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Application for Membership toTHE DANISH ASSOCIATION "HEIMDAL" Inc., BRISBANEApplicant First Name, SurnameOccupationPlace of birth and/or connection with <strong>Den</strong>markDate of birthMobile PhonePartner First Name, SurnameOccupationPlace of birth and/or connection with <strong>Den</strong>markAddress – StreetTown / Suburb / PostcodeDate of birthMobile PhoneHome PhoneFaxe-mail address1, Childs Name Date of birth2. Childs Name Date of birth3. Childs Name Date of birth4. Childs Name Date of birthhereby apply for admission as Fee per year tick oneOrd<strong>in</strong>ary Member(s) receiv<strong>in</strong>g newsletter (must be of danish $50.00desent)Associate Member(s) not receiv<strong>in</strong>g newsletter $25.00Associate Member(s) receiv<strong>in</strong>g newsletter $50.00of the <strong>Danish</strong> Association "Heimdal" Inc. and if selected I (vi) promise to obey Rules and By-Laws.I declare that the above <strong>in</strong>formation is correct.(signed) ................................................................................. ......................200…..........----------------------------------------------------------------------------------------------------------------COMMITTEE's REMARKSProposer Seconder Date AcceptedFee of $……..…Cash / ChequePaid on Recorded Receipt numberPlease make cheques payable to "Heimdal" and post to:Eilean Nielsen28 Netherby Rise, Sunrise Beach QLD 4567Ph(07) 5447 2737E-mail: nielsensbeach@smartchat.net.auwww.danishclubbrisbane.org page 17
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