Shiv Shakti Cultural and Education (City of Moreton Bay) Association Inc.
ABN: 61131179717
Applicant Details
Full Name
*
First Name
Last Name
Residential Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Mobile Number
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Country of Birth
Age Group
18 and under
19 to 35
36 to 64
65 and over
Gender
Male
Female
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Membership Details
Membership Type
Foundation Member(FY25-26)
Life Member
Ordinary Member
Seniors Group
Date of Application
-
Day
-
Month
Year
Date
Proposer and Seconder
Note: Proposer and Seconder must be current members in good standing.
Proposer Details
Proposer Full Name
Proposer First Name
Proposer Last Name
Proposer Membership Type
Foundation Member
Life Member
Proposer Signature
Date
-
Day
-
Month
Year
Date
Seconder Details
Seconder Full Name
Seconder First Name
Seconder Last Name
Seconder Membership Type
Foundation Member
Life Member
Seconder Signature
Date
-
Day
-
Month
Year
Date
Applicant Declaration
I hereby apply for membership of Shiv Shakti Cultural and Education (City of Moreton Bay) Association Inc. and agree to abide by its Constitution, Rules, and Code of Conduct. I understand that my application is subject to approval by the Management Committee.
Member (Applicant) Signature
*
Date
-
Day
-
Month
Year
Date
Office Use
Reviewed By:
First Name
Last Name
Reviewed Date
-
Day
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Month
Year
Date
Committee Decision
Accepted
Rejected
Remarks
Date Approved
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Day
-
Month
Year
Date
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