American Women's Club of Perth

GPO Box T1669 Perth Western Australia 6001

E-mail:  Website: http://www.awcperth.org

APPLICATION

 Membership Categories

Renewal of Membership

Payment Options

Cash, Check or Money Orders

Payment must accompany your application. All forms of payment are to be in Australian Dollars. Checks need to be from an Australian Bank and payable to American Women’s Club of Perth. You may send check or money order by mail, however please DO NOT send cash by mail. We invite you to bring membership payment to any meeting or event and join in the activity. Please give payment to the 1^st Vice President Membership or any other board member.

MEMBER INFORMATION:

(Please Print)

Last Name:   First Name:   Middle:

Address: 

City:   State:  Post Code:

Home Phone:   Mobile Phone:    Fax:

E-Mail:    Birth Month: Day: Year:

USA Home State or Country of Citizenship:  

If you are a student, list school attending:  

Member’s Company Affiliation/Employer:

Type of Business:  Position:  Business Phone: 

How would you like your name listed in the directory? 

How would you like your name to appear on your name badge?  

Would you like to receive communications via email: Yes    No 

How would you like to receive the monthly newsletter:     Post   Email or Both

SPOUSE/PARTNER INFORMATION:

Name:   Citizenship: 

Company Affiliation/Employer: OCCUPATION:

Children’s Names and DOBs :  (Fixed size to not go over 2 lines)

I agree to abide by the Constitution and By-Laws of the American Women's Club of Perth during my membership. (Copies are available upon request.) 

I agree that I have read and understand the Membership and Annual Due requirements.

The annual dues payment deadline each year is March 15^th. If dues are not paid prior to the April meeting you will be a Late Active member without AGM voting privileges. If annual dues are not paid within 2 months of the due date, you will have to rejoin as a new member following those guidelines.

Each member will be provided with an AWC name badge, Constitution, By-Laws and Club directory upon joining the AWC. Replacement name badge cost is $10.00.

Your name, address, phone numbers, e-mail address, hometown, spouse/partners and children’s name will be published in the Club directory (Unless requested otherwise).

SIGNATURE: ____________________________________________________ DATE: ______________________

American Women’s Club of Perth

Application for Membership

CONTINUED

Please take the time to fill out this form.   We’d like to know more about you!

What is your main interest in joining the Club? 

If you used a relocation company when moving to the Perth, who were they and did they provide you with information about the Club?  Where did you hear about the AWC?

Educational/Professional background:  (Fixed size to not go over 4 lines)

Please list affiliations with other Women’s Clubs (present, past and overseas):  (Fixed size to not go over 4 lines)

Please circle the activities you are most interested in:

Please list other activities you would like to participate in (if not listed above): (Fixed size to not go over 5 lines)

Comments:   (Fixed size to not go over 5 lines)

Office Use Only:

Checklist for Member file: