TABLELANDS RADIO & ELECTRONICS CLUB Inc.  PO Box 682  Atherton  Qld  4883  E-mail  vk4wat@wia.org.au APPLICATION FOR MEMBERSHIP  Name of Applicant          Callsign:   V K (Christian Name)                                     (Surname)  Address of Applicant              (Postal Address)                                                              (Residential Address)  ................................................. ................................................. ................................................. .................................................  ................................................. ................................................. ................................................. .................................................  Home Phone:   (07) ___________ ________   Work:  (07) _________________  Mobile:  ______________________  E-mail address:           XYL/OM Name:  @ Are you a member of the Wireless Instit ute of Australia (WIA)         Yes                 No  Applicant Birthday:                                                    DD MM       YYYY Interests of benefit to TREC ?  _____________________ ___________________________________  Name of Proposer:  ___________________  Calls ign:   VK_______   Signature: ________________  Name of Seconder:  ___________________  Ca llsign:   VK_______   Signature: ________________  Class of Membership applied for:     Ordinary Member     $30.00            Associate Member  $12.00 p/a    I, the above named applicant wish to become a me mber, (Class of Membership shown above), of the  Tablelands Radio & Electronics Incorporated.  I understand the fee for membership is payable on subm itting this application and if such application is  rejected the total fee will be refunded to me.  Once becoming a member of the Club, I hereby agr ee to be bound by the Rules and Regulations and the  Constitution of the Club.  Signature of Applicant:  ___________ ________      Date: ____/____/____  Acceptance date: Fee received:              Data entered into data-base:  / / Office use onl y VK4DMC 2009
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