FORM ADUG:MEM

I,
(full name of Principal Applicant)

of
(residential address)

Postal address:

Email address:
Contact telephone No(s):

certify that I am over 18 years of age and, having read the conditions of Membership appearing in this Application for Membership, hereby apply to become a Member of Amiga Downunder UG Incorporated and, if my Application is accepted, agree to pay the dues required (namely, the relevant Entry Fee and subscription for the first year of my Membership, as and when advised by the Secretary after this Application Form has been processed, as well as all subsequent annual subscriptions for as long as I remain a Member) as a condition of being accepted as a Member.

In the event of my being admitted as a Member, I understand that my Membership will not take effect until the appropriate dues have been paid, and I agree, on behalf of myself and the other individuals included in this Membership Application, to be bound by the Constitution of Amiga Downunder UG Incorporated.

I further understand that:

a) As a Member, I will be identified by my Membership
Identifier (Membership ID) and that this will be the
email address that I have given on this Application;

b) That my Membership will not take effect until my
Membership dues have been paid, and payment of those
dues has been acknowledged; and

c) That my Membership includes myself (as the Principal
Applicant) and up to five (5) additional persons who
share my email address, live with me and are members
of my immediate family, as listed below.

Details of the other individuals to be included
in the Membership are:

1. Name:
   Relationship to Principal Applicant:

2. Name:
   Relationship to Principal Applicant:

3. Name:
   Relationship to Principal Applicant:

4. Name:
   Relationship to Principal Applicant:

5. Name:
   Relationship to Principal Applicant:

Full Name of Principal Applicant:
Date:

NOTES:

1. This Membership covers one email address,
   and up to six individuals, all of whom must be
   related to, and reside with, the Principal Applicant.

2. No matter how many persons are nominated,
   this Membership is entitled to only one vote.

3. Separate email addresses require
   separate Memberships.

Any ADDITIONAL information that you can give about yourself and your interests and association with the Amiga will help to make ADUG more effective as a User Group.

For example:

Are you a member of any other User Group? YES/NO
If YES, what is the name of your User Group?

My User Group is:

MEMBERSHIP INFORMATION:
The Membership year starts on 1st September of each year
and ends on 31 August of the following year.

DUES:
For Residents of Australia:
Entry Fee: A once-only payment of AUS$15.00
PLUS
An Annual Subscription of:
AUS$10.00 for a full Membership year (7 months or more)
or
AUS$5.00 for half a Membership year (6 months or less)

For Residents of New Zealand:
Entry Fee: A once-only payment of NZ$18.00
PLUS
An Annual Subscription of:
NZ$12.00 for a full Membership year (7 months or more)
or
NZ$6.00 for half a Membership year (6 months or less)

This Form, duly filled in, should be emailed to:
secretary@amigadownunder.org

- the Amiga User Group for all Australasians -