Poona

Poona Community Progress Association

 
   

Membership Application

In accordance with the Associations Incorporations Act 1981 the Poona Community Progress Association advises that it holds Public Liability Insurance cover to a level of $20m.


First Name     Surname

Birth Date

 

Addresses

Postal Address (full)
eg 7 Snapper Drive, Poona 4650

Other (eg Poona) Address
eg 7 Snapper Drive, Poona 4650

Phone & Email Details

Landline Phone Mobile

Email

Details of Nominee

Nominee     Member's #

By checking this box and submitting this application I confirm that I have-

  • the support of my stated Nominee, and
  • I acknowledge that I must at all times abide by the Association's Code of Conduct.
  • I have paid, or will deposit the $5 membership fee to the below bank account
    • Name: Poona Community Progress Assoc.
    • Westpac Bank - BSB: 734 128
    • Account Number: 071337
    • For the reference please include your name. Please also email the Secretary to advise of payment.