I......................................................................hereby apply to become a

Member of The Queensland Master Farriers Association Inc under the following conditions

1. I agree to pay an annual subscription to the association ($100).

2. I agree to be bound by the constitution and rules of the association.

3. I agree to provide proof of my eligibility to become a member of the Association.

Please state Trade Qualifications (eg Trade Certificate, Apprenticeship, Certificate of Recognition)

Certificate................................................................................................................................................................

Certificate Number..................................................................................................................................................

(Please enclose a photocopy of Certificate of Completion of Apprenticeship. Not necessary if you have been a member in the past.)

Date Obtained...........................................................................................................................................................

Date of Birth..............................................................................................................................................................

Address.....................................................................................................................................................................

.................................................................................................................................................................................

.................................................................................................................................................................................

Phone....................................................................................... Mobile.....................................................................

E-mail........................................................................................................................................................................

Signed....................................................................................... Date........................................................................

Return to

S. Crosbie

15 Ennor St

Wavell Heights Qld 4012