Individual Membership Application

Type of membership:: New Membership $40Renewal $40
Your Details:: First Name:
Last Name:
DOB:
Address:: Line 1:
Line 2:
City:
Country:
State:
Postal Code:
Phone Number:
Mobile:
Email Address:
Signature:
Date:
: Hereby apply for individual membership of Radio Televisione Italiana SA Inc. (“The Association”).

I understand that as a member of The Association I accept to abide and be bound by the Constitution and any rules and regulations which may be changed at any given time according to the Constitution.

I acknowledge this application is subject to approval by the Committee and the Committee will approve 50 only new members each calendar year.

I acknowledge that until I am approved as an Individual Member, in accordance with the Constitution, that I am not entitled to any benefits of Membership, including voting rights.

I acknowledge The Association reserves the right to refuse this application or revoke a membership where the information provided herewith is incorrect.
: Payment - On completing this form, you will be directed to our Make a Payment page ( Online Credit Card Payment ). Membership will be complete once payment is made.
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ADDRESS

Unit 3, 215 Port Road, Hindmarsh SA 5007

OFFICE

STUDIO