| Please fill out the information following and send it to the Club at : Mouse Club WA 15 Virginia Ave Maddington, WA 6109 Listing your postal address is optional, but please make sure you include an email address if you don�t wish to be contacted via post. All members details will remain private and are only viewed when posting information and newsletters. Age and birthdates are requested as general information to plan for club meetings and events. Details are never released without prior approval. All persons under 16 years of age require parental consent before joining the club, and should be accompanied by an adult at all shows or events. Each individual wishing to join is to use a separate form. If there are not enough forms available, writing the requested details on a separate piece of paper is acceptable. Please ensure you contact us if any of your details change. Details will be kept on record by the Club and will need to be submitted by entrants with any show entries. If you wish to remove yourself from the club at any time, contact us at [email protected] and we will remove you ASAP. MOUSE CLUB OF WA APPLICATION FORM: Your name: Gender: M / F Postal Address: (Including postcode) Email Address: Age or D.O.B: (under 16�s need parental consent through a hand written and signed letter sent with this form.) Number of mice owned: Males or females? Do you breed your mice? Y / N If so, would you like to register a mousery under your name? Y / N (Mousery applications will be sent out with a general code of conduct) I wish to be contacted via email only. Y/ N I wish to be contacted via post only. Y/ N I wish to receive newsletters and show notifications. Y/ N Signature:������������� Date:������ Once your application is received you will be sent a confirmation letter with your club membership number. It is recommended you keep the number for future references. |
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| Mouse Club of Western Australia |