Individual membership

Name *

First Name

Last Name

Unit address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Individual membership fee of $25 has been paid ($5 once off joining fee and $20 annual fee for individual membership) has been paid via bank deposit to BSB 082 980 ACC 829 382 063

Membership fee has been paid

I apply to be admitted to an individual membership of the above identified Owners Corporation Network ACT. If granted a membership, I agree to be bound by the rules of association for the time being in force. *

I agree

Date

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