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| Staffordshire Bull Terrier Club of Northern NSW Inc |
| (Affiliated with Dogs NSW Inc) |
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| Application for Membership 2009
- 20 |
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| Membership Type □ Renewal □ New Membership |
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| Name |
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| Address |
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| Phone |
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| email |
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| Prefix |
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| RNSWCC Ltd Membership No: (or equivalent) |
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| Signature/s |
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| As a member of The Staffordshire Bull Terrier Club of Northern NSW Inc, I/We will comply with the Code of Ethics and abide by the constitution of The RNSWCC Ltd (or equivalent) |
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| Nominated by committee member |
| Name Signature |
| Membership Fees |
| AUD $30.00 (July 2009 - June 2010) |
| New Zealand - $33.00 |
| UK and Rest of World subscription $37.00 |
| All remittances must be in Australian Dollars only |
| Cheques to be made payable to Staffordshire Bull Terrier Club of Northern NSW Inc |
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| The Secretary |
| PO Box 534 |
| Cessnock NSW 2325 |
| Office Use Only| Date Passed Cheque Number |