EPSS P&C Membership Form 2010

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This form is for the Everton Park State School P&C found at http://evertonparkstateschool.blogspot.com/

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EPSS P&C Membership Form 2010

  1. 1. EVERTON PARK STATE SCHOOL Parents & Citizens Association Formed February 1953. Registered under “The Charitable Collections Act of 1952 Deakin St, EVERTON PARK QLD 4053. ABN: 24 392 685 811 Membership Form - 2010/2011 (Please forward completed forms to P&C c/- school office, or come along to the AGM in February) Name: ___________________________________________________ Address: ___________________________________________________ Phone: __________________________________________________ Email: __________________________________________________ Name & class of youngest __________________________________________________ child at school Your date of birth (if no __________________________________________________ child at school) Applicant's Signature __________________________________________________ _____________________________________________________________________________ Office Use Only Membership Approved: Yes/No Date on register: __ / ___ / _____ President's Signature: _______________________________

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