QUEENSLAND UNIVERSITY REGIMENT

ASSOCIATION

New members
Home Back

New members

QUEENSLAND UNIVERSITY REGIMENT ASSOCIATION

24 Walcott  Street, St Lucia,  4067

NOMINATION FOR MEMBERSHIP

 I, _____(leave blank)_________________________   nominate _______(your name) _________________________

For membership of the Queensland University Regiment Association Incorporated 

Signed: ___________________________

 

 I, _____(leave blank)_________________________   second _______(your name) _________________________

 

For membership of the Queensland University Regiment Association Incorporated

Signed: ___________________________

 =====================================================================================

 Candidates should complete this section

 Title or Rank:  ________ Initials:  _______   Surname:_______________________________

Preferred Christian Name:  ___________   Post Nominals:  __________________________

 

Address: __________________________________________

___________________________________________________________________

 

_______________________________________________    Post Code:  ________

 

Email Address: ____________________________________

 Telephone (Bus):    ____________________   Telephone (A/Hrs)    ____________________

Period of Service in QUR:  19____   to 19_____    Commissioned in QUR   Yes / No

Postings in QUR:____________________________________________________________

 Corps: ____________________    Present Unit (if applicable):  _______________________

 

I accept nomination for membership, tender the prescribed fee, and, if elected, agree to abide by the Rules and By-Laws of the Queensland University Regiment Association Incorporated.

 Signed:  ________________________________         Date:  ____ / ____ / ____

 _______________________________________________________________

Annual subscription is $10.00 Ten year membership is $70.00
   
Please note all correspondence is by email so please ensure correct email address  

 _______________________________________________________________

FORWARD YOUR CHEQUE TO: The Treasurer
  QUR Association
  C/- 24 WALCOTT STREET ST LUCIA Q 4067
   
For those members with internet banking, payments may be made direct to the QURA Bank Account.  
DETAILS ARE:- Account Name QUR Association Inc
  BSB 064 129
  ACCOUNT 0090 4500
  (Please ensure your name is supplied in the payment details)

 _______________________________________________________________

*****************************

To send your nomination via Email, please copy the nomination form details (by highlighting the complete form and then pressing Ctrl C), click on the Email address below and then paste the form (Ctrl V) into the Email.  You may then complete your details in the Email and send to the Membership Registrar.

Membership Registrar - Trevor Luttrell 0437 442 964 - Email QURA Secretary

*****************************