APPLICATION FOR MEMBERSHIP -----> OBA of St John's College,Jaffna Victoria Branch, Australia

PERSONAL DETAILS Name Address City Code Phone Phone (Bus) (Self - Old Student / Staff at College - Please specify periods) � � (Spouse - Old Student / Staff at College - Please specify periods) � � (Children - Old Students / Staff at College - Please specify periods) � �
� N umber -------------------- Paid Through ____________________ � Subscription Details Annual Fee $15 per Year Life Member $ 150 Students, Pensioners $5 per Year Due on 1st January of each year. � Please foward cheque made payable to "OBA St John's College" to Dr M Sivakadadchan 34 Canopus Drive Doncaster East 3109 T.No (03) 9842 4060 � �	I agree, if admitted as a member of the Old Boys Association St John's College, Jaffna to confirm to the Charter and by-laws of the Association. � � � ------------------------------------------------ (Signature) � � _________________________________ (Date) � �

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