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NATIONAL SERVICEMEN'S ASSOCIATION OF AUSTRALIA

New South Wales Branch Inc.
A National Branch with the Approval of the Association National Council
THE HOME OF THE NATIONAL SERVICEMEN
State President: Frank Boissett.  State Secretary:Colin Shapland
                          Tel: 0499440070                    Tel: 02 63378378

MEMBERSHIP NUMBER:_N___________________

NEW MEMBERSHIP $25.00
(Joining fee includes the cost of The Association lapel badge)

RENEWAL FEES EACH YEAR - $20.00
From 1st January to 31st December inclusive)

PAYMENT:   Please pay your Sub-Branch directly.  (Sub Branch details to be entered in the space below by Sub Branch)
N.S.A.A. NSW State Branch................................................................................................................................ Sub-Branch Stamp.

PO Box 401
 MITTAGONG NSW 2575

 ELIGIBILITY FOR MEMBERSHIP:
       Former National Servicemen 1951-1959 Navy - Army - Air Force and 1965-1972 Army
       Former or Serving Members of the Citizen Military Forces - Army Reserves, RANR or RAAF Reserves
       Former or Serving Members of the Australian Regular RAN – Army - RAAF
       Former Members of the Allied Forces - or any non-service person, interested in the welfare of the National Servicemen’s Association 

Surname:

Given Names:

Date of Birth:  ____ / ____ / ____

Email Address:

Address:

PO Box:

Suburb/Town:

Post Code:

Home Tel:

Mobile:

Work Tel:

Fax:

Occupation:
(If retired, state former occupation eg. Retired Engineer/Carpenter, etc.)

I would like to be a member of the ________________________________________________________________ NSAA Sub-Branch.           As per the attached list and post it to the Secretary of that Sub-Branch. 
SERVICE MEMBERS ONLY

Branch of Service             Navy              Army             Air Force

Service Number:

Rank:

Corps/Unit/Squadron:

Period of Service:  _____ / _____ / _____  to  _____ / _____ / _____

 

 I hereby declare the above information to the best of my knowledge is an accurate record of my Military Service, and any disclosure of false information could void my application and or may result in my exclusion from the Association.

             Are you a member of an RSL Sub-Branch?   YES   NO.
       Do you require information on RSL membership?   YES  NO.
       Spouse a member?   YES  NO.
       With reference to the Privacy Act, do you AGREE or DISAGREE for your details being made available to any other organisation?

                                                                                                                                                                                                                                         PLEASE ALLOW 21 DAYS for the receip of your membership card and lapel badge

Signed:  .............................................................................................................

Date:  ____ / ____ / ____

Nominated By:  .................................................................................................

NSAA Membership Number:......................................................

 For Office Use only:

PAID TO:      STATE                                               

MEMBERSHIP FEES PAID:  ____ / ____ / 20____

MEMBERSHIP APPROVED:    YES                   NO.

DATE APPROVED:  ____ / ____ / 20____