Illawarra Dressage Association Inc.

   

 

 

                                                            (ABN:   27 923 643 044)    

                                     

                              Proudly Sponsored by

 

 

               2009 Membership Application  

 

 

We/I hereby apply for membership of the Illawarra Dressage Association Inc.

       

Family Name:

Given Name/s:

Address:

P/C:

Email:

Contact Nos:

BH:

AH:

Mobile:

Please tick:                    

Rider

 

Non Rider

 

DOB: (21yrs & under)    

                   

  

Please complete below for Family/Stud Membership ONLY: 

Rider Name:                                                                                                   DOB: (21yrs & under)  

Rider Name:                                                                                                   DOB: (21yrs & under)

Non Rider Name:  

Non Rider Name:

 

 Membership Fees:

Individual Membership

$45.00

 Membership fee includes a $10 joining fee

Family/Stud Membership

$55:00

NB:   Membership will expiry if renewal is not received before:   31st of January 2010

 

I have enclosed cash / cheque / money order in the sum of $ _____________ for

                                                                                                               (Total Amount)                   

____________________________________

                  (Membership Type) 

 

Signature:   _____________________________________    Date: ____________

(If under 18 years, parent or guardian must sign)

 

 

At Events I/We would be willing to assist with: (please circle)

Pencilling

Collection of Score Sheets

Gear Stewarding

Public Relations & Prize Distributing

Other: (please specify)

 

Text Box: Office use only:   Membership Accepted       Yes / No   Payment made by: Cheque      Cash       Money Order   Receipt No:                        Mbrship No:

 

 Please return together with payment to:

 

 Illawarra Dressage Association Inc.

 Secretary

 PO Box 193

 Thirlmere    NSW    2572

 

Illawarra Dressage Association Inc.

    (ABN:   27 923 643 044)    

                                       

                                          Proudly Sponsored by

 

 

               2009 Membership Application  

 

 

We/I hereby apply for membership of the Illawarra Dressage Association Inc.

       

Family Name:

Given Name/s:

Address:

P/C:

Email:

Contact Nos:

BH:

AH:

Mobile:

Please tick:                    

Rider

 

Non Rider

 

DOB: (21yrs & under)    

                   

  

Please complete below for Family/Stud Membership ONLY: 

Rider Name:                                                                                                   DOB: (21yrs & under)  

Rider Name:                                                                                                   DOB: (21yrs & under)

Non Rider Name:  

Non Rider Name:

 

 Membership Fees:

Individual Membership

$45.00

 Membership fee includes a $10 joining fee

Family/Stud Membership

$55:00

NB:   Membership will expiry if renewal is not received before:   31st of January 2010

 

I have enclosed cash / cheque / money order in the sum of $ _____________ for

                                                                                                               (Total Amount)                   

____________________________________

                  (Membership Type) 

 

Signature:   _____________________________________    Date: ____________

(If under 18 years, parent or guardian must sign)

 

 

At Events I/We would be willing to assist with: (please circle)

Pencilling

Collection of Score Sheets

Gear Stewarding

Public Relations & Prize Distributing

Other: (please specify)

 

Text Box: Office use only:   Membership Accepted       Yes / No   Payment made by: Cheque      Cash       Money Order   Receipt No:                        Mbrship No:

 

 Please return together with payment to:

 

 Illawarra Dressage Association Inc.

 Secretary

 PO Box 193

 Thirlmere    NSW    2572