APPLICATION / RENEWAL OF MEMBERSHIP

Applies to be accepted as a member of
CL NETWORK VICTORIA INC

I agree to pay the annual membership fee currently group $25.00

Individual $10..00 and be bound by the rules of the Association

Please pay membership fees to:
CL NETWORK VICTORIA INC

Bendigo Bank
BSB: 633-000
Account No: 148115777

SIGNATURE OF INDIVIDUAL APPLICANT

Signature of duly appointed representative of the applicant Community Group ( name of current member & Community Group)
C/o Peter Lalor Community Campus Address: 34 Robert Street, Lalor VIC 3075 Email: info@whittleseacln.org.au