12/27/09

      Australian Silky Terrier Club of Queensland 
 

• Please copy this, or print out, fill in and send to The Secretary.
  Membership application / new!

  Australian Silky Terrier Club Qld.
  Secretary: Carol Sands                 
  Ph: (07) 32946654
  347. Junction Rd KARALEE. QLD. 4306
  E-mail: sandswept@bigpond.com
   

  Membership application / renewal

  I / We Kennel prefix;--------------------------------------------------------

  ~Optional;  Note: You don’t have to be a breeder to be a member. ]

  Address; -----------------------------------------------------------------------------

  Postcode; ---------------------------------------------------------------------------

  Phone no. ( A / I-I ) ( Bus.) ------------------------------------------------------

  Fax; no.------------------------------ Email address; ---------------------------

  Nominated by------------------------------ Seconded; --------------------------

  l / We enclose the appropriate fees of $--------------

  Signed; -------------------------

  Date ; ----------------------------

  Fees; -----------------------------

  Single;  $12.00 / Double; $18.00 / Junior: $ 6.00

  Please fill in form and return to:      
  The TREASURER/ renewal only
   

   Australian Silky Terrier Club Old.
   
  Ann Rohde

                                          396. Park Ridge Rd. Park Rdge. QLD. 4125

                                      E-mail:

                                  Fax: / Ph: (07) 38033062 
   

  Membership fees must be paid by last day of September

                   Fill in details below for the receipt of your Newsletter

  Name; ------------------------------------------------------------------------------

  Address; ----------------------------------------

  Postcode; ------------------
   

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