Membership Registration – Indian Society of WA

MEMBERSHIP LOGIN DETAILS

*Email

*Password

PERSONAL DETAILS

*Name

*Date of Birth (dd-mm-yyyy)

*Country of origin

*Address

*Suburb

City

*State

*Post Code

Home Phone

Work Phone

*Mobile

Email

Citizen

Spouse Email

Spouse Name

CHILDREN IF MEMBERSHIP PRIVILEGES DESIRED (UNDER 18 YEARS)

Child Name 1

Child Name 2

Child Name 3

Child Name 4

Declaration

We solemnly affirm that:

to abide by the Constitution of the Indian society of W.A. at all times and by rules that the Management Committee may establish periodically.
to advise the Secretary in any change in my/our contact details of the corporation.
that my/our contact details may be used by ISWA for communicating activities and newsletter on ISWA’s activity.
To any verification of the information provided on this form and understand that the membership will be effective form the date this application is approved by the Management Committee.

I/We understand that the latest copy of the Constitution is always available at the Society’s office for members to read.

Signature of Applicant:

Date:

Signature of Spouse (only if for a joint membership) :

Date: