AUSTRALIAN ROCK 'n' ROLL DANCESPORT COUNCIL INC. PO Box 863, Balkham Hills NSW 1755 Phone (02) 9688 7000 Facsimile (02) 9688 7011 APPLICATION FOR NEW or RENEWED MEMBERSHIP Applicants Name: Mr/Mrs/Ms/Miss etc.: . . . . . . . . . . . . . . . . . . . . . . . Postal Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State: . . . . . . . . . . . . . . . . . . . . . Post Code . . . . . . . . . . . . . . CURRENT GRADING and STYLE

I hereby make application for admission as an . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
of the Australian Rock 'n' Roll Dancesport Council Inc. and attach the mebership fee of: . . .
$50 Professional Coach Level 1 2 3 4 5
$40 Professional Member/Dancer
$20 Registered Adult
$15 Juvenile/Junior/Minor $45 Family (2 Adults and 2 or more children)
$10 Remote/Country Member
$0 Volunteer Member
Which I understand will serve as my annual subscription for the year . . . . .
(period ending 30th June . . . .)

I Hereby endeavour to support the ARRDC, advance its objects, and abide by its Rules and Regulations.

Signature of Applicant: . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . .

Signature of Guardian: . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . .
(if applicable)

Please complete and sign this form. Payement can be in the form of bank draft, postal order or cheque. Thank you for your membership.