JBAC Membership Form

Schedule 2 - Membership Application Form

I

of

(address)

Town/Community

born on

(date of birth)

apply for membership of the Joombarn-buru Aboriginal Corporation RNTBC (ICN 9583)

Telephone number

Country CodeArea CodePhone Number

Email address

example@example.com

Apical ancestor

If you have more than one apical ancestor, select their name in the box below.

Apical ancestor

List additional apical ancestors (if more than one).

Grandparents names

Parents names

Signature of applicant

Date

Directors confirmed applicant is eligible for membership in accordance with rule 5.3.

Date entered on the Corporation's register of members (must be within 14 days of acceptance (rule 5.7)

Rule Book of Joombarn-buru Aboriginal Corporation RNTBC (ICN 9583 Registered by a Delegate of the Registrar on 20 March 2023.