Application

APPLICATION FOR MEMBERSHIP OF AN INCORPORATED ASSOCIATION

(Associations Incorporation Act)

Information for applicants:

If your application is accepted, your name and address, as provided, must be recorded in a register of members and may be made available to other members, upon request.
If the obligations under the Association Incorporation Act 2009 are not complied with, Association can be wound up.
You can contact the Association at admin@loosh.org.au
You can access or correct personal information by contacting the Association as indicated above.

APPLICATION FOR MEMBERSHIP TO LEICHHARDT OUT OF SCHOOL HOURS ASSOCIATION INCORPORATED

First Parent/Guardian*

First Name Surname

Address*

Suburb*

Childs name/s*

School child attends*

Home phone*

Work phone*

Mobile*

Email*

Second Parent/Guardian*

First Name Surname

Address*

Suburb*

Childs name/s*

School child attends*

Home phone*

Work phone*

Mobile*

Email*

I/We:

apply to become member(s) of the Leichhardt Out of School Hours Association Incorporated (‘the Association’).
declare the information above is true and correct.
agree to be bound by the Association’s constitution, rules, policies and procedures.

Signature of First Parent/Guardian*

Date*

Signature of Second Parent/Guardian*

Date*

Phone

This field is for validation purposes and should be left unchanged.