APPLICATION FOR FAMILY MEMBERSHIP 2006 VICTORIA
It is necessary to be a financial member of the Association in order for you and your children to participate in Suzuki
Music activities. This form is to apply for Family membership of Suzuki Music in Victoria only.
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.
There is a special rate for country members (outside metrpolitan area). Please contact the office for more details.
N
ew member (see below)
$15 joining fee +
= $
Joining in
Jan/Feb/March pay $15 + $69
Apr/May/June pay $15 + $52
Country Members $15 + $54
Country Members $15 + $42
Jul/Aug/Sept pay
$15 + $35
Oct/Nov/Dec pay $15 + $18
Country Members
$15 + $28
Country Members
$15 + $14
Renewing member (Membership No:..................)
1 Year
$69.00
1
Year
(after
31
March) $88.00
Country Members 1 Year
$54.00
Country Members (after 31 March)
$69.00
Dr /Mr /Mrs /Ms /Miss (Please circle)
Parent's Given Name ___________________________________ Parent's Family Name ______________________________________
Address ____________________________________________________________________________________________________________
City _______________________________________________________ Postcode _____________________________________________
Telephone Home ___________________________________ Business _____________________________________________________
Mobile___________________________ Fax _________________________ Email_______________________________________________
Child's Family Name
Child's Given Name
Childs Middle name
Sex F M Date of Birth
Instrument/s Teachers
Name
Payment : (Please tick) Cheque/Money Order (payable to Suzuki Music) Cash Credit Card *
If paying by credit card* please fill in the details below: ( Bankcard Visa Mastercard )
*Credit Card payments will incur an additional 2% surcharge.
Name on card (Block letters):
Signature:
Card No:
_ _ _ _ /_ _ _ _ / _ _ _ _ / _ _ _ _
Card Expiry Date
_ _ / _ _
Please note a tax invoice/receipt will be issued upon request only. All prices include GST
A NON-PROFIT ORGANISATON
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. Reg. No. A5744
ABN 14 080 413 955
