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TE AWAMUTU SPCAPO Box 386Te AwamutuPhone 07 871 5222
Please print this form and mail it with your payment to the address shown above Name: Address: Phone: Are you able to assist with volunteer work Yes No Are you able to assist with fundraising(cake stalls, raffles, garage sales etc) Yes No If you are able to assist as above, are you happy for your phone number to be given to a committee member so they may contact you Yes No Membership Fees Life Membership $ 100.00 Adult $ 10.00 Senior Citizen $ 6.75 Family $ 20.00 Junior $ 5.00 Donation TOTAL ENCLOSED Signature Date