To join The Orpington Club of Australia (overseas members are welcome) =
copy between the bold dotted lines to an A4 piece of paper - fill in detail and post with payment (AU dollars)
to the Secretary
( for Other Variety/s = as example - Blue Cuckoo, Birchen, Partridge, Lavender )
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The Orpington Club of Australia (Inc)
Secretary – Martin Doulton
Secretary@orpingtonaustralia.com
MEMBERSHIP APPLICATION/RENEWAL. 2021/2022
Name (Mr/Mrs/Ms.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postal Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Post Code/Zip Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone . . . . . . . . . . . . . . . . . . . (include area code for landline numbers) - mobile . . . . . . . . . . . . . . . . . . . .
Email address (for Newsletter by Email, essential for overseas Members, please print clearly and in correct case.)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I Enclose
Annual Subscription (1st July to 30th June) $20 p.a. ………………$ * $10 for Junior Members
Donation towards Club Show ……………….$
(please nominate your preference)
Club Badge (stitch on type) $15 ....................$
(delivered via OZ Post)
TOTAL ………………….$
Please make remittance to the Secretary by Money Order or Cheque payable to The Orpington Club of Australia
contact the Secretary for mailing details OR if paying via Internet Banking Direct Bank Credit
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IMPORTANT – PLEASE COMPLETE THESE DETAILS
I KEEP THE FOLLOWING VARIETIES OF ORPINGTONS – (X)
LARGE FOWL BANTAMS
BLACK ………..………. BLACK ……….……….
BUFF ……….………. BUFF ………..………
BLUE ……….………. BLUE ………..………
WHITE ……….………. WHITE .……….………
CUCKOO ……….………. CUCKOO ………..……….
SPLASH ……….………. SPLASH ………..……….
CHOCOLATE ..................... CHOCOLATE ......................
OTHER VARIETY/S - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (use back of page if more room needed)
cps
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STRIKE OUT WHICH EVER DOES NOT APPLY ( XX / XX )
I OCCASIONALLY HAVE STOCK FOR SALE YES / NO
I AM WILLING TO SELL EGG SETTINGS YES / NO
I GIVE PERMISSION TO HAVE MY CONTACT DETAILS PROVIDED YES / NO
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* Junior Members under 16yrs old, please supply year of birth
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Club Badge ^ (picture not to scale) actual size = 7cm in diameter
