CLUB RENEWAL/APPLICATION FORM (circle one)
Club Name _________________________________________
Club Representative ___________________________ ICORE No. ___________
Rep's Address _______________________________
_______________________________
_______________________________
Phone No. __________________________________
E-mail _____________________________________
ICORE Member Name ___________________________ ICORE No. ____________
ICORE Member Name ___________________________ ICORE No. ____________
ICORE Member Name ___________________________ ICORE No. ____________
Fees: Due 1st January Each Year
New Club - $100 per year
Club Renewal - $80 per year
Does your club have regularly scheduled matches or events that you want
included on the ICORE web site and the Cylinder's Turn newsletter? Include
details.
Event: ___________________________________________________________
Schedule: ________________________________________________________
Location: _________________________________________________________
Contact: __________________________________________________________
Phone: ___________________________________________________________
Email: ___________________________________________________________
Web site: _________________________________________________________
Event: ___________________________________________________________
Schedule: _________________________________________________________
Location: _________________________________________________________
Contact: __________________________________________________________
Phone: ____________________________________________________________
Email: ____________________________________________________________
Web site: _________________________________________________________
Print and POST THIS COMPLETED FORM TO: "Attention Bev. Simpson", The Treasurer, 16 Blackwood Cres, Cobram, 3644 Victoria.
ALL
Payments for Fees, New Membership or Membership Renewals are to be made payable
to ICORE AUSTRALIA and posted to "Attention Bev. Simpson", The Treasurer, Icore Australia, 16 Blackwood
Crescent, Cobram, 3644 Victoria.