Fill in your details below, click the PRINT button on your browser
and send with cheque to:

QATA
C/- The Treasurer
4 Tingara Court
Boyne Island, QLD 4680

Print another copy to keep as your official Tax Invoice

Membership Application 2005-2006

Tax Invoice
ABN 3362 3020 966

Name: 
School:
Telephone: 

(w)
(h)

Fax:
Email:
Residential Address:
Type of membership
applied for (please circle):

Ordinary - $25.00
 Student - $10.00

I enclose annual membership subscription.

Signature: _________________           Date:    ________

         

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