Muswellbrook Mechanical Coursing Club Ltd

Greyhound Park, Sydney Street, Muswellbrook NSW 2333

Phone (02) 6543 2351 Fax (02) 6543 3707

A.B.N. 74 002 855 763 Affiliated with the G.B.O.T.A.

Application for Membership

 

I,                                                                of                                                                     

HEREBY APPLY for membership of the above club and, if accepted, agree to be bound

by the rules and decisions of the Club.

DATED this                              day of                                      200    

 
SIGNED:  
ADDRESS:  
   
OCCUPATION:  
 

PENSION NUMBER REQUIRED:
NOMINATOR:  
NOMINATOR:  

 

WHERE THE STARS RACE UNDER THE MOON