GVLA Inc - Membership Application form

GOULBURN VALLEY LAW ASSOCIATION INC.
APPLICATION FOR NEW MEMBERS
Your name
Where do you work?
Your address
Your email address
example@example.com
Are you a member of the LIV?
I make application to become a member of the Goulburn Valley Law Association Inc .

On approval of my application for membership, I agree to:

a) support the purposes of the Goulburn Valley Law Association Inc (found in the Rules of Goulburn Valley Law Association Inc ("the Rules");

b) to be bound by the Rules which have been provided to me before signing this application.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signed
Should be Empty: