Affiliated Group Membership | Queensland Quilters

Membership Form: Affiliated Group Membership Application

1st April 2018 to 31st March 2019
Please complete this form to join or to renew your group membership of Queensland Quilters.

If you are human, leave this field blank.

Group Name *

Contact Person *

Contact Position *

Email *

Please enter your email address

Address *

City *

State

Postal Code *

Membership Number

Phone Number

Type Number including area code, without any spaces: 0712345678

Mobile

Type all numbers without spaces: 0421345678

New members *

We welcome new members

We cannot accept new members

We agree to have our details circulated to other groups / quilters/ appropriate businesses *

YES

Time *

Day of the week/month *

Please indicate second Tuesday each month, for example

Venue *

Address *

City *

Postal Code *

Affiliated Group Members *

Financial Member during 2017: $60

New and Non-Financial Member: $65

Payment Amount $

We agree to sell Queensland Quilters Inc. Art Union tickets. Number of books of tickets we can sell (10 tickets per book)

Number of Books you would like to sell *

Date *

Signature *