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The Dante Alighieri Society of Cairns, Inc. PO Box 2615, Cairns 4870 Qld. MEMBERSHIP APPLICATION
Name/Nome ____________________________________________________________ Surname/Cognome _________________________________ Address/Indirizzo ___________________________________________ E-mail _____________________________________________________________ Tel No/Telefono _________________________________________________________
Renewal ______ New Member _____ (Please tick which is applicable) I am interested in being on the Dante Organizing Committee Yes______No______ Subscription (circle): $30 Single $45 Family $20 Student &/or Pensioner I enclose cash / cheque for $_____________ payable to: The Dante Alighieri Society (Cairns) Inc. or Bank Deposit to
BSB: 484799 ACC: 31901931
(Members will receive our Monthly Newsletter, and discounts on our dinners and events).
Signed:_______________________________________ Date:________________ |