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Retired OnLine Inc

Retired OnLine Inc. NM11-12

APPLICATION FOR MEMBERSHIP.

( PLEASE PRINT ALL INFORMATION IN CAPITALS)

Surname:.................................Mr, Mrs, Ms, Miss. Given Name:....................Card Name

Address......................................................Suburb................................Postcode................

Telephone:................................................Mobile..................................................

Email: (CAPITALS PLEASE).....................................................................

Do you own a computer? Yes / No

Is it IBM compatible Yes / No Windows Version.............................

Computer Skill - Nil......................Semi Skilled..............................Skilled.......................

Subscription Fee of $15.00 is enclosed: Yes / No

h I am over 50 years of age and wish to apply for Full Membership.

 

h I am over 45 years of age and wish to apply for Associate Membership.

 

I agree to the above personal details being entered into a Membership Register.

h I am over 30 years of age and wish to apply for Associate Membership.

 

I agree to the above personal details being entered into a membership Register.

Signed.........................................................................Date..............................................

Proposed by.................................................................ROL Membership No:............................

Seconded by................................................................ROL Membership No:............................

Please return your application form with Cheque/Money order (no cash in mail)

If you wish your card posted to you, please include a stamped self addressed envelope.

To:

The Treasurer,

Retired OnLine Inc.

P.O. Box 850,

Elanora. Qld. 4221

Office Use Only.

New Membership No:.............................

Treasurers Receipt No:..........................

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

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