Victorian Waterfowl Association Inc.
                                                                   Incorporation number A0016025A

Membership Application Form (please print out and foward to the membership secretary).

Name:…………………………………………….

Address:……………………………………………………………………………………

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Phone Number:…………………………………Email…………………………………..

I am interested in: (please circle)                Large or Light Ducks

                                                                Bantam Ducks

                                                                Geese

Are you interested in qualifying as a Waterfowl Judge?        Yes/No

Annual Subscription:- if paid before 31st March (2008) If after March 31st please add $5.00 to the listed fees. Adults $25.00        Family $45.00
                                                                                                                                                                    Juniors $10.00 (under 16 years of age)

Subscription includes reduced entry fees for our shows, breeders directory and subscription to ‘The Waterfowl’ magazine.

                  
Subscription year is from 1st January to 31st December.

The Breeders Directory is included free with membership. Additional copies can be purchased for $5.00each.            Number Required           [                   ]

Cheques should be made payable to : “Victorian Waterfowl Association Inc.”

Applications should be forwarded to:

Mrs Gail Kneeshaw
VWA Membership Secretary
PO Box 132
Alexandra Vic 3714

New subscribers joining after 30th September will receive a copy of the October issue of “The Waterfowl” and their subscription will apply to the following calendar year.

Please list the breeds and colours of waterfowl you currently keep.

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May our Association include these details & your Name & Phone number in our Annual Breeders Directory?

                Yes     /      No  (please circle appropiate)



Signed:…………………………………………

Date: ………/………/………