QCAS Next Generation

Membership Application 2014/15

1st April 2014 - 31 March 2015 $11.00 GST INC

I,______(Full name)

Agree to being over the age of 15 years and under the age of 40 years, hereby apply for membership of QueenslandChamber of Agricultural Societies Inc. Next Generation Committee as an Ordinary Member

Annual Membership Fee for 12 months QCAS Next Generation Committee membership 1st April 2014 - 31 March 2015 $11.00 GST INC

Please note that the Next Gen Committee AGM will be held on the 29th March 2015 at the Rocklea Showgrounds and you are invited to attend

  • My cheque/money order/cash/direct debit remittance for $______being the Membership Fee is enclosed.
  • Direct Debit Details: QCAS NG: BSB: 064 000 A/C: 12881952
  • If direct debiting please ensure you enclose original membership form along with remittance to PO BOX 240, ROCKLEA QLD.
  • If direct debiting please use the reference: NG Membership – (Surname)
  • My Donation of $______for the Zimbabwe and Queensland Exchange Bursary is also enclosed.
  • I understand that the Management Committee will consider this application at its next meeting after the Secretary receives it, and the Secretary will advise me in writing of the Committee’s decision.
  • I understand that, if I am admitted as a Member–
  • my name, my residential address, and the history of my membership of the QCAS Next Generation will appear in the Register of Members, (which may be inspected by anymember); and
  • only those personal contact details that I have supplied overleaf may appear on a ‘Contact List’ which may be circulated to the Management Committee, the Queensland Chamber of Agricultural Societies Inc. and its authorised Staff, but not to any other person without my written permission.
  • I understand that, if I am admitted as a Member, the Management Committee will grant me (the Member) –
  • such other concessions, so long as I remain a Financial Member, as the ManagementCommittee shall from time to time allow to Members; and
  • the rights of an Ordinary Member, including the rights to vote at a General Meeting of the Society and to hold an Office of the Association.

I acknowledge and agree that as a Member I am bound by the Rules of the QCAS Association (a copy of which is available from the Secretary on payment of the prescribed fee) and I agree that I will comply with the Rules whilst I am a Member.

______

SignatureDate

Please post to

Queensland Shows Next Generation Committee

PO Box 240, ROCKLEA, QLD 4106

or email to

Please TURN OVER to complete contact details

CONTACT DETAILS

  • Please ensure that you provide your Full Name and Current Residential Address (overleaf).
  • If you do not specify a mailing address, correspondence will be sent to your Residential Address.
  • Minutes of Meetings will be sent to your email address. If you do not supply an email addressyou may collect Minutes and other reports from the Administrator at the Office.

Name:______

Date of Birth: ______

Mailing Address: ______

Phone: ______

Email: ______

Show Society:______

Specific Role/s: ______

Interest Areas: ______

Are you a member of any other show societies? If so please list details.

______

Are you making a donation to the Zimbabwe and QLD Bursary?

Please tick. Yes □ No □Donation: $______

Accepted by QCAS Next Gen: ……………………………………. On ….. /….. /………

Payment Received: ………………………………… Receipt Number: …….……………………………..

QCAS Next Generation | C/- PO Box 240, Rocklea QLD 4106| Phone 0427 322 781 (Amy Wicks)

or 0418 889 630 (Janine Milne) | Email: