Joining Jan - Mar
Joining Apr - Jun
Joining Jul - Sept
Joining Oct - Dec
New Member - Paper
$15 + $58 = $73
$15 + $44 = $59
$15 + $29 = $44
$15 + $15 = $30
New Member - Email
$15 + $54 = $69
$15 + $41 = $56
$15 + $27 = $42
$15 + $14 = $29
Renewing Member - Paper
$58
$73
$73
$73
Renewing Member - Email
$54
$69
$69
$69
FAMILY DETAILS -
Please circle the membership category that you are applying for in the table above.
Dr/Mr/Mrs/Ms (Please circle)
Parent's Given Name _______________________________ Parent's Family Name ______________________
Membership Number (if renewing) ________ Address ______________________________________________
City _________________________________________________________ Postcode ________________________
Telephone Home ____________________________________ Business __________________________________
Mobile __________________________________ Email ________________________________________________
(Must be provided for Email Membership)
PAYMENT DETAILS
Please note, a tax invoice/receipt will be issued upon request only. Prices include GST.
Amount Paid $
______________
Cheque/Money Order Credit card* ( M'CARD / VISA )
(Payable to Suzuki Music)
* Credit Card transactions will incur a 2% surcharge
Card Number
_ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Expiry date
_ _ / _ _
Name of Cardholder
__________________________________
Signature
______________________________________
A NON-PROFIT ORGANISATION
PO Box 439 · KEW EAST · VIC · 3102
Ph: (03) 9859 0433 · Fax: (03) 9859 0477· info@suzukimusic.org.au · www.suzukimusic.org.au
Suzuki Talent Education Association of Australia (Vic.) Inc. T/As Suzuki Music Reg No. A5744
ABN 14 080 413 955
Application for Victorian Country Family Membership 2007
It is necessary to be a financial member of the Association in order for you and your children to
participate in Suzuki Music activities.
·
Families may choose from a Paper Membership (all correspondence from Suzuki Music will be sent to you by
mail), or an Email Membership (all correspondence from Suzuki Music will be sent to your designated email
address).
·
Members receive the bi-monthly Suzuki Notes with details of all Suzuki Music activities and you can also take
advantage of special offers and discounts through the Suzuki Music Member Bonus Program. Membership
renewals not paid by 31 March will incur a $19 late fee. Country families will incur a late fee of $15.
·
The Membership year is from 1 January - 31 December. New Families who join during the year pay a $15
joining fee plus pro-rata fees except where a student is graduating and then the whole year's fees must be
paid.
·
Country family membership is only available to members with a home phone number starting with 5.
Child's Family
Name
Child's Given
Name
Child's Middle
Name
Sex
F M
Date of
Birth
Instrument
Teachers
Name
