FIELD & RETRIEVING ASSOCIATION FOR GUNDOGS INC 

2017 Membership Form


FIELD & RETRIEVING ASSOCIATION FOR GUNDOGS INC.

MEMBERSHIP   FORM   NEW APPLICATION   OR   RENEWAL 
 

Field & Retrieving Association

for Gundogs Inc.

Affiliated with Dogs Queensland ABN 81 301 979 447

 

President:                                                      Secretary:

Bob Boodnikoff                                                            Geoff Dawson

Phone: 0409278302                                           Address:67-69 Hawthorn Rd

E-mail: [email protected]                       Burpengary, QLD,4505

                                                                                                                    Phone: 38866367

                                                                                     E-mail:[email protected]

                                                                                               

 

Application for membership or renewal form

 

NOTE: The Financial year for the Field & Retrieving Association for Gundogs Inc. ends 30 September each year and Membership Fees are due and payable on or before 1 October each year.

Please tick (✓) appropriate boxes where applicable

Fees:                Single $15.00                Joint $20                                               For Year  2017

Type:    New                         Renewal                   Single                                  Joint   

Title:     Mr                             Mrs                           Ms                                        Miss   

Surname: ............................................................        Given Name/s: .......................................................

Address: ………........................................................................................................................................

State: ........................  Post Code: ............................. E-mail: ..............................................................

 

Postal Address (if different to above): ......................................................................................................

State: ........................  Post Code: .............................

Phone:  Home: ....................................................Mobile: .......................................................................

Breed/s: ...................................................................................................................................................

CCC (Q) Membership Number: ...............................................................................................................

Do you wish to receive your Newsletter by E-mail?                      Yes                          No  

I/we hereby apply for Membership/Renewal of membership of the Field & Retrieving Association for Gundogs Inc. and, if accepted, agree to abide by the Constitution of both the Field & Retrieving Association for Gundogs Inc. and Dogs Queensland.

Signed: ...............................................................         Date: ...........................................................................

Signed: ...............................................................         Date: ...........................................................................

 

Check's payable to ‘Field And Retrieving Association For Gundogs Inc’

Or pay by 'Direct Deposit' to:-  CUA Bank – BSB No:    814-282

Account Number:          30229198.

Please use your name & reason for payment as the reference eg  Wade - membership

                                                                                                                                                                                                        

CLUB  USE  ONLY:

Amount received: ................................                               Receipt number: .............................................

Date received: .....................................                                Date approved: ................................................

 

_________________________________________________________________________________________

 

 

 

 

 

 

 

 




Dogz Online - Dogs, Breeders, Puppies