ASTS
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ASTS Membership Application Form

(Please print this form and send to "ASTS, PO Box 40, Epping NSW 2121)
Contact Information:

Title: Surname: First Name:
Chinese Name: (if any)
Postal Address:


Phone(HOME): (WORK) :
Fax: Email:

Statistical Information:

Sex: Date of Birth:
Field of Study:
Highest Degree:
Current Employer:

Declaration:

I, , hereby apply to become a member of the Ausinan Science & Technology Society, and $20 Cheque (payable to Ausinan Science & Technology Society) is included as my membership fee for the first year. I agree to be bound by the rules of the Society for the time being in force.
Signature: Date:

Nominations:

I, , a member of the Ausinan Science & Technology Society, nominate the applicant, for membership of the Society.
Signature: Date:

I, , a member of the Ausinan Science & Technology Society, second the nomination of the applicant, for membership of the Society.
Signature: Date:

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