Name _____________________________________________________ Date Of Birth_______________ Residential Address (you must supply a residential address- P.O box alone is unacceptable). ______________________________________________________________________________________________________ Mailing Address _______________________________________________________________________________________ Town/ Suburb_________________________________ State_____________ Post Code_______________ Drivers Licence No.______________________________ State _________________ Expiry ____________ Phone____________________________________ Fax No._______________________________________ Mobile ____________________________________ e-mail_______________________________________ Occupation/ Skills________________________________________________________________________ Single Membership Fee.. $30 AU for 12 months membership .. includes a $10 joining fee for new members. Choose a Method of Payment Cheque Money order Applicant: I agree that the information i provided on this form is true and correct..
You must be at least 18 years of age to join MAKO,unless in a family membership situation.
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