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, Chocolate )
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The Orpington Club of Australia (Inc)
Secretary – Martin Doulton
965 Macclesfield Road
Yellingbo,Vic. 3139
Secretary@orpingtonaustralia.com
MEMBERSHIP APPLICATION/RENEWAL. 2016/2017
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 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 ………..……….
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
