Membership Application Form

NAME & CONTACT DETAILS

First Name*

Last Name*

Email*

Enter Email Confirm Email

Mobile Phone*

Phone (Other)

RESIDENTIAL ADDRESS

Street Address*

Street Address Line 2

Suburb / Town / City*

State*

Postcode / ZIP*

Country*

POSTAL ADDRESS

Postal Address the same as the Residential Address above?*

Yes
No

Postal Address*

Postal Address Line 2

Postal Address Suburb / Town / City*

Postal Address State*

Postal Address Postcode / ZIP*

Postal Address Country*

MEMBERSHIP OF ANOTHER CHAPTER

Are you or have you been a member of another Chapter?*

No
Yes

Chapter Name*

MEMBERSHIP OPTIONS

Joining January 01st to June 30th

Joining July 01st to December 31st

Select A Membership Option*

$307.00 AAC National & AAC-QLD
Full Membership
$226.00 AAC National & AAC-QLD
Full Membership
$210.00 AAC-QLD
Full Membership
$165.00 AAC-QLD
Full Membership
$40.00 AAC-QLD
Social Membership
$40.00 AAC-QLD
Social Membership

FINALISE MEMBERSHIP APPPLICATION

Proposer

Seconder

Acceptance*

I AGREE

I agree I shall at all times be bound by the Memorandum & Articles of Association of the Australian Aerobatic Club (Queensland Chapter) Limited and any Rules and By-Laws which may be in effect from time to time.

Date*

Digital Signature

If you have your signature as an image file (jpg, jpeg, gif, png, or pdf) you can sign your membership application digitally by attaching your signature file.

DIRECT DEPOSIT BANKING DETAILS

Please direct deposit your membership fees into the AAC-QLD bank account, using your surname as the reference.

Bank	Westpac Banking Corporation
Account Name	Australian Aerobatic Club (Qld Chapter) Limited
BSB	034-115
Account Number	164115
Reference	Your surname

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