Australian Scrabble Players Association Queensland

Membership details for year 1^st July 2007- 30^th June 2008

Membership fees: Single - $12.00, Family - $18.00, Unaffiliated - $17.40

First Name………………………………………. Surname……………………………................

Address……………………………………………………………………………………………...

Suburb/Town………………………………………………………… Post Code…………………

Phone No (H)………………………………… (Mob)………………………………………….

Email Address………………………………………………………………………………………

How do you wish to receive your ATB? Printed only….. Email only….. Both….. (Tick 1 only)

Club……………………………………………… Amt Encl…$..................................

Cheques Payable to ASPA Q

The quarterly magazine will be sent to the club you nominate. If not a member of a club, put unaffiliated.

All details provided are for use by A.S.P.A.(Q) and CASPA only.

Please put the word Silent after your phone number if you do not want it given out to other players.

Rec no:_______________ Date:_____/_______/______

Membership Officer – Jane Brown 24 Maker St, Toowoomba Q 4350. jb.edits@bigpond.net.au