Morrinsville Country Music Club (Inc.)
PO Box 240
Morrinsville 3340

2011/2012 Membership Form

Individual $20.00 Family $30.00

Membership Name: _________________________________

Mother Club :______________________________________
(This is the club that members will be affiliated to NZCMA under
and is a NZCMA requirement.)

Address: _________________________________________

________________________________________________

______________________________Postcode: __________

Phone: _____________ E-Mail: _______________________

Family Members (for Family Membership):               DOB:

________________________________________/___/__

________________________________________/___/__

________________________________________/___/__

________________________________________/___/__

________________________________________/___/__

________________________________________/___/__

Please note:
* Approved at 2009 AGM: 18 years old and over @ 1 August
are required to pay an Adult Membership.
* Birthdates are required for all members who enter awards
and to enable our newsletter editor to enter members names
onto our birthday list.