Membership Form

Membership Form

Application for Membership of Planetary Healing Artists Association of Australia Inc. (PHAAA)
Applicant
I, First Name* Last Name* ,

of Street Address* Suburb/City* * Australia,

would like to become a member of PHAAA. In the event of my admission as a PHAAA member, I agree to be bound by the rules of the Association for the time being in force.
Signature of Applicant ({applicant:firstname-1} {applicant:lastname-1})*

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Date/time recorded automatically
Email Address of Applicant ({applicant:firstname-1} {applicant:lastname-1})*
Proposer
I, First Name* Last Name* , a member of PHAAA, nominate the applicant ({applicant:firstname-1} {applicant:lastname-1}), who is personally known to me, for membership of PHAAA.
Signature of Proposer ({proposer:firstname-1} {proposer:lastname-1})*

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Date/time recorded automatically
Seconder
I, First Name* Last Name* , a member of PHAAA, second the nomination of the applicant ({applicant:firstname-1} {applicant:lastname-1}), who is personally known to me, for membership of PHAAA.
Signature of Seconder ({seconder:firstname-1} {seconder:lastname-1})*

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Date/time recorded automatically
Should be Empty:

Applicant