![](3D"MIATMEMBERSHIPFORM_files/image002.jpg")
APPLICATION FOR MEMBERSHIP TO MIAT
(MAJOR
ISSUES & THEOLOGICAL CENTRE INC)
INC: 9876684 ABN: 9719=
5897416
Name:
________________________________________________________________
Address:
______________________________________________________________
State: __________________________________ Postcode: __________________=
____
Telephone: ___________________________ Facsimile:
________________________
Email: _____________________________________
Occupation: _________________________________
I hereby apply to become a:
o &nb=
sp;
FULL MEMBER
o &nb=
sp;
ASSOCIATE MEMBER
o &nb=
sp;
CONCESSIONAL MEMBER
of the Major Issues and The=
ology
Centre Incorporated. In the e=
vent
of my admission as a member, I agree to be bound by the rules of the
Association for the time being in force.
Signed: ________________________________________
Date: __________________________________________
Sponsor<=
/o:p>
1, ___________________________________________________=
being
a member of the MIAT nominate
the above applicant who is
personally known to me for membership of the MIAT.
SEND TO: C MITCHELL, RMB 2559 GEORGE DOWNES DRIVE, KULNARA, =
NSW,
2250
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