DCC Membership Application

Membership Application
Complete this form and email to doncastercameraclub@gmail.com

Direct deposit the annual membership fee to: BSB: 033389 Account: 125370
Individual $65.00Family $95.00Associate or Full time student $40.00
For family memberships please complete one form per member. Your emergency contact should not be

another member of the Doncaster Camera Club.

Please accept my application for membership of the Doncaster Camera Club (Association)
My Details
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Date of Birth

DayMonthYear
Date
How did you hear about the Doncaster Camera Club?
My Emergency Contact Details

First NameLast Name
Relationship to you
Phone

Area CodePhone Number
Email
example@example.com
I support the purposes of the Association and agree to comply with the rules of the Association. I consent to the disclosure of my name, address and contact details (only to club members) via the club membership list. I consent to the Club posting to the Club's social media sites any images I enter in Club competitions.
Signed

Clear
Date

DayMonthYear
Date
Membership approved at Committee Meeting

Return form to Secretary for filing:

Pam Rixon, Secretary DCC, PO Box 2043 Box Hill North VIC 3129

www.doncastercameraclub.org.au

doncaster camera club - melbourne
Should be Empty: