MEMBERSHIP FORM
MEMBERSHIP FEE JUNE 2009-JULY 2010 A$60.00
SENIORS (55+) & STUDENTS A$30.00
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FIRST NAME: SURNAME: |
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ADDRESS: POST CODE: |
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MOBILE NUMBER: HOME PHONE: |
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EMAIL ADDRESS: |
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SPECIALITY: |
PLEASE FILL IN FORM IN FULL
PROFILE YOU WANT TO HIGHLIGHT ON THE AHWBN WEBPAGE (Max 100 words)
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Year you arrived to Australia and with whom: |
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Studies you previously had: |
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Studies you completed in Australia: |
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Work done in Australia (paid and/or voluntary): |
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Any Highlights you wish to share with the Network: |
Please Make Electronic Transfer or deposit AHWBN
of A$60.00 to: St George
City Centre
BSB 112 879
ACC 429252753
Account Description: Your full name – MEMBERSHIP
Please Email Filled Form and recent colour photo to: reception@ahwbn.com
or post full membership with photo and cheque to: AHWBN
512/910 PITTWATER Rd
DEE WHY NSW 2099
AUSTRALIA
DATE:___________