APPLICATION FOR MEMBERSHIP

I/We …………………………………………………………………………………………

(Name of Applicant/Company/Partnership)

of …………………………………………………………………………………………….

Residential/Business Address

………………………………………………………………………………………………..

Postal Address – if different from above)

Hereby apply to become a member of the Australian Subtropical Coffee Association Inc.  In the event of my/our admission as a member, I/We agree to be bound by the existing rules of the Association and any amendment(s) to the rules which from time to time may lawfully be made.

……………………………………………….. Date:……………………………...

Signature of Applicant(s)

Occupation or Nature of your interest in Australian Subtropical Coffee:

………………………………………………………………………………………………..

Business/Trading Name: ………………………………………………………………...

Web site: ………………………………....................................................................... 

Email address: ……………………….........................................................................

Phone: ………………………………… Mobile: ……………………………

If you are a grower, please provide the following information:

No. coffee trees you have planted in total: ……………...

No. coffee trees in production this year: ………………

FEES:  

Joining fee……………………………………………………. $25

Annual subscription (September to August)…………… $50

(part year after February)……….. $25

Please pay when lodging your application – pay by cash, cheque or direct deposit to account:  BSB 802 222     Account No 22271328

Please forward this application form and payment (proof of payment if made by EFT) to: The Treasurer ASTCA,    

PO Box 6335,     

South Lismore    

NSW  2480