CaMILA Registration Form

CaMILA Membership Registration

Complete the form below to sign up for our membership service.
Name*

First NameLast Name
E-mail*
My country of origin *
If you are Australian, what is your parent country's of origin?
Mobile Number*
Please enter a valid phone number.
Phone Number (Land Line):

Area CodePhone Number
Home address:*

Street Address

Street Address Line 2

SuburbState

Post CodeCountry
Date of Birth*

DayMonthYear
Field of work / Profession*
Membership Rules
1. Membership is available to any MUSLIM Ladies, residing in Cairns, 18 years of age or older.

2. You promise NOT to use to conduct any fraudulent or business activity or have more than one Member Account at any time.

3. Yearly fee $15, by bank transfer to BSB : 084 583, Account no : 35 39 64 091

4. Rules may be amended/added by managing committee.
Once you submit your application, we will contact you shortly to complete your membership application. Thank you!
Signature*

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CaMILA Membership Registration