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Membership Application
Membership to 30th June 202.........

Date......................................

Name/s............................................................................

Address...........................................................................

Address...........................................................................

Phone No........................................................................

Mobile No........................................................................

Email..............................................................................

Membership
$15.00 per Family or $10.00 single   $............
Plus joining fee incl. badges
$14.00 per family or $7.00 single       $...........

Total                                                   $.............

Badge name/s.................................................................

                          ..............................................................

Signature........................................................................

Send to Treasure
Julie Charlton
90-92 Riflebird Drive
Upper Caboolture Q 4510

BANK DEPOSIT DETAILS
Northern Districts Horticultural Society
Commonwealth Bank or Australia
BSB: 064110  Acc No 00904391

Amount $......................................

Description  eg Membership

Surname & Initial..........................



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