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The Station takes your privacy and your private information seriously and will not disclose any information you provide in this form without your written consent except as required by law Privacy This information will become part of the members register, details of which are available for viewing by any member of the Co-operative Full Name: Address: OR (1) I hereby apply and in respect of such application lodge herewith, in accordance with the rules of the Society, the sum of $ . which is made up as shown hereunder: Required Information: o o Contact me at the station. My address will be 11 Fitzgerald Street, Windsor, NSW, 2756 I agree to my details being made available to other members under the Cooperatives Act NSW 1992. Office Use Only Folio reference: Admitted o Date Admited: NB: PAYMENT OF APPLICABLE FEES MUST ACCOMPANY APPLICATION Shares are refundable to the applicant upon resignation from the society or may be passed onto the Society as a donation. (a) to be admitted as a new member of Hawkesbury Radio Communications Co-operative Society Ltd - $20.00 for purchase of five (5) Shares plus $27.50 (being $25.00 plus $2.50 GST) for Annual membership up to the next Annual General Meeting - Total: $47.50 (b) Presenters Annual Fees (where applicable) - $33.00 (being $30.00 plus $3.00 GST) (c) To be allotted: ____ additional shares in Hawkesbury Radio Communications Society Ltd (Purchases in lots of five only) (2) If this application is approved and the shares as foresaid be allotted to me, I will agree to pay all charges required by the Society and I agree to be bound by the rules of the Society and all alterations thereof registered with the above named Act. (3) I am over the age of 18 years ..... o Yes o No Dated this ___________________ day of ____________________ month __________________ year. Signature of applicant Signature of Witness Name of Witness (Print) { } Witness/Sponsor: (Must be an active member of the Co-operative) o o Contact me at the station. My address will be 11 Fitzgerald Street, Windsor, NSW, 2756 I agree to my details being made available to other members under the Cooperatives Act NSW 1992. Office Use Only Folio reference: Admitted o Date Admited: Application for Membership or Additional Shares Co-operatives Act, 1992 Hawkesbury Radio Communications Co-operative Society Ltd Contact Information: This information is not part of the members register, and is collected to assist the station in considering your application and in our normal operations. It is not available to other members unless you approve it in writing or by checking the box above Residential Address: Post Code Post Code Post Code Postal address for forwarding any mail sent to us at the station (If different from above) Home Phone: Mobile No: Business Phone: Fax No: Email Address: Occupation: Date Of Birth © Copyright 2014/2 Hawkesbury Radio Communications Co-operative Society Ltd The Station takes your privacy and your private information seriously and will not disclose any information you provide in this form without your written consent except as required by law Privacy This information will become part of the members register, details of which are available for viewing by any member of the Co-operative Full Name: Address: OR (1) I hereby apply and in respect of such application lodge herewith, in accordance with the rules of the Society, the sum of $ . which is made up as shown hereunder: Required Information: o o Contact me at the station. My address will be 11 Fitzgerald Street, Windsor, NSW, 2756 I agree to my details being made available to other members under the Cooperatives Act NSW 1992. Office Use Only Folio reference: Admitted o Date Admited: NB: PAYMENT OF APPLICABLE FEES MUST ACCOMPANY APPLICATION Shares are refundable to the applicant upon resignation from the society or may be passed onto the Society as a donation. (a) to be admitted as a new member of Hawkesbury Radio Communications Co-operative Society Ltd - $20.00 for purchase of five (5) Shares plus $27.50 (being $25.00 plus $2.50 GST) for Annual membership up to the next Annual General Meeting - Total: $47.50 (b) Presenters Annual Fees (where applicable) - $33.00 (being $30.00 plus $3.00 GST) (c) To be allotted: ____ additional shares in Hawkesbury Radio Communications Society Ltd (Purchases in lots of five only) (2) If this application is approved and the shares as foresaid be allotted to me, I will agree to pay all charges required by the Society and I agree to be bound by the rules of the Society and all alterations thereof registered with the above named Act. (3) I am over the age of 18 years ..... o Yes o No Dated this ___________________ day of ____________________ month __________________ year. Signature of applicant Signature of Witness Name of Witness (Print) { } Witness/Sponsor: (Must be an active member of the Co-operative) Application for Membership or Additional Shares Co-operatives Act, 1992 Hawkesbury Radio Communications Co-operative Society Ltd Contact Information: This information is not part of the members register, and is collected to assist the station in considering your application and in our normal operations. It is not available to other members unless you approve it in writing or by checking the box above Residential Address: Post Code Post Code Post Code Postal address for forwarding any mail sent to us at the station (If different from above) Home Phone: Mobile No: Business Phone: Fax No: Email Address: Occupation: Date Of Birth © Copyright 2014/2 Hawkesbury Radio Communications Co-operative Society Ltd
