KOREA VETERANS ASSOCIATION OF AUSTRALIA Inc.
MEMBERSHIP/RENEWAL |
|
|
|
|
Name:..................................................................................... |
Subscription |
$25.00 |
|
Address:................................................................................. |
Pocket Badge (optional) |
$10.00 |
|
.............................................................................................. |
Lapel Badge (optional) |
$10.00 |
|
State:.............................. Postcode:........................................ |
Donation (optional) |
$_____ |
|
Phone No: ( )............................................... |
Mobile:............................................................................. |
|
|
Email:........................................................... |
TOTAL |
$_____ |
|
Service Number:............................ Unit:................................. |
|
|
|
Where:............................................................ |
|
|
|
When:............................................................. |
|
|
|
Signature:........................................................ |
|
|
