AUSTRALIAN FEDERATION OF UNIVERSITY WOMEN - A.C.T INC.
APPLICATION FOR MEMBERSHIP
| NAME (IN BLOCK LETTERS) | Dr Miss Ms Mrs......................................................................................................... |
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POSTAL ADDRESS: |
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POSTCODE:...................................................... | ||
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PHONE NO: (HOME)................................................................. |
(BUSINESS):...................................................... | ||
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DETAILS OF QUALIFICATIONS
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DEGREE (S) |
IN WHAT FIELD |
UNIVERSITY |
YEAR OF GRADUATION |
PRESENT EMPLOYMENT (please be specific)
ANY OTHER PROFESSIONAL EXPERIENCE:
OTHER INTERESTS (e.g. Comunity, Arts & Crafts, Cultural, Educational, Sporting, etc.)
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AGE GROUP: |
(20-25) |
(26-35) |
(36-45) |
(46-55) |
(56-65) |
(over 65) |
Have you belonged to any other Association of AFUW or IFUW? if so give details:
I WISH TO BECOME A MEMBER OF THE AUSTRALIAN FEDERATION OF UNIVERSITY WOMEN - ACT INC.
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SIGNED: .......................................................................................... |
DATE: ..................................................... |
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PLEASE RETURN TO: |
THE MEMBERSHIP SECRETARY |
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AFUW-ACT INC | |
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G.P.O. BOX 6141, O'Connor, | |
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ACT 2602 |
WITH THE ANNUAL SUBSCRIPTION OF $65.00 AFUW Home Page