Membership Application

First Name:		Last Name:
Partner's name:		Species /Area of Interest
Address:
Business/Farm Name:

Home Phone:		Bus Phone:
Mobile:		Fax:
Email:
I agree to be bound by the rules of the Association. Copy of model rules available upon request.
Signature:		Date:

Please print this form, fill out details, sign, and mail, together with the annual membership fee (cheque or postal order), to:-

	Secretary/Treasurer , NSW Aquaculture Association Inc
	PO Box 8,
	Bulahdelah NSW 2423