Application for Membership

FORM

Australian Racing Christian Chaplaincy Incorporated (ARCC Inc) (incorporated under the Associations Incorporation Act, 1984)

I,............................................................................................(Full name of applicant)

of ...........................................................................................(postal address)

...............................................................................................(telephone number)

...............................................................................................(mobile number)

...............................................................................................(facsimile number)

...............................................................................................(e-mail address)

...............................................................................................(occupation)

I hereby apply to become a member of the abovenamed incorporated association and forward a membership application fee of $20 (including GST). I understand that the fee will be refunded to me should my application for membership be declined.

In the event of my admission as a member, I agree to be bound by the rules of the association for the time being in force and I declare that I agree with the Mission, Vision, Goals and Doctrinal Statement of its Constitution. As well, I understand that membership is renewable on 1 July of each calendar year.

................................................................................................Date .......................

Signature of applicant

I,...................................................................................a member of the association,

(full name) nominate the applicant, who is personally known to me, for membership of the association.

................................................................................................Date .......................

Signature of proposer

I,...................................................................................a member of the association,

(full name) second the nomination of the applicant, who is personally known to me, for membership of the association.

................................................................................................Date .......................

Signature of seconder

MEMBERSHIP FEES/DONATION

Membership Fee: $20................................................................................................

Donation: $..............................................................................................................

Total: $....................................................................................................................

My cheque for $..................................................................................... is enclosed.

Please post your completed application form and cheque or money order to: