|
APPLICATION FOR MEMBERSHIP OF
THE QUEEN JADWIGA FOUNDATION INC.
To become a member please
fill out the form and send to:
The Queen Jadwiga Foundation
P.O.
Box 654
Toorak
3142
Victoria
I,
.
,
(name and occupation)
of
..
..
desire to become
(address)
a member of The Queen Jadwiga Foundation Inc.
Please
select a Level of Membership:
(*)
Level of Membership (select one):
Royal family member - (by invitation only)
Regional Office Chairman - (by invitation only)
The QJF Council Associates - (by invitation only)
The
QJF Advisory Council Associates (must hold PhD degree) - $100 and up
Chairmans
Club - $5,000 and up
Founders
Club - $1,000 4,999
Patron
- $500-999
Benefactor
- $250-499
Member
- $100
Associate
- $50
Student
- $25
Level of Membership (*): ------------------------------
In the event of my admission as a member, I agree to
be bound by the rules of the Foundation for the time being in force.
.
.
Signature of
Applicant
Date
|
