SNFTAAS MEMBERSHIP APPLICATION

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SURNAME____________________________________________________

FIRST NAMES_________________________________________________

ADDRESS_____________________________________________________

______________________________________________________________

______________________________________________________________

PHONE________________________ FAX  ________________________ _

EMAIL______________________________________

CHEQUE for ___________ enclosed.

SIGNATURE___________________________________

DATE________________

I wish my name/address to remain confidential: YES NO

Please print, complete and post this form along with your payment to:

Secretary
Eliz Halford
R.D. 10, Hiwinui,
Palmerston North,
New Zealand


Please consider recording your history with SNFTAAS in an accompanying letter.
(State if you do not wish it to be circulated to other members.)