Bush Music Club Inc. - Membership Form

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Membership

Application Renewal

Name *

Membership No

(Renewals only - if known)

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Options

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Membership Type *

One year:	Single ($30)	Family ($40)	Pensioner ($20)	Affiliation (clubs only, $70)
Five year:	Single ($120)	Family ($160)	Pensioner ($80)	Affiliation (clubs only, $280)

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Direct deposit details: BSB 062-005 (Commonwealth Bank) Account 0090 7524
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