Natural Sequence Association

Upper Shoalhaven Chapter 

(Incorporated under the Association Incorporation Act 1984)

Membership:   Lea Barrett, P O Box 369, Braidwood, NSW 2622, Mobile: 0411892957 

APPLICATION FOR ANNUAL MEMBERSHIP:  $30 per person or $45 for family

Please make cheques payable to: Natural Sequence Association Upper Shoalhaven Chapter.   

I (full name of applicant)_________________________________________________________________________________________________________

 of  (postal address)______________________________________________________________________________________________________________

and (email address)_______________________________________________________________________________________________________________

apply to become a member of the above named incorporated association.  In the event of  admission as a member, I agree to be bound by the rules of the association for the time being in force.

____________________________________________________________   ______________________________________

(signature of applicant)                                                            (date) 

To be completed by NSA US office:

I, __________________________________________________________________a member of the association, nominate the applicant who is personally known to me,  for membership in the  association.

(signature of proposer)                                                                                                             (date)

I, _______________________________________________________________a member of the association, second the nomination of the applicant, who is personally known to me, for membership in the association.

(signature of seconder)                                                                                                            (date)