MEMBERSHIP APPLICATION FULL NAME ADDRESS POSTCODE DATE OF BIRTH .. PHONE:Home . Work/mobile Fax . Email FIREARMS LICENCE NUMBER ...  CATEGORIES & PURPOSE . Signature of applicant   Date . I (print name) , a member of NMSC Inc propose the applicant for membership to Northern Midlands Sporting Clays Inc. Signature of proposer ..   Date I (print name) .. , a member of NMSC Inc second the applicant for membership to Northern Midlands Sporting Clays Inc. Signature of seconder    Date . MEMBERSHIP FEES ADULT  $90.00      PENSIONER   $85.00      JUNIOR (under 18) free Return to : Northern Midlands Sporting Clays Inc. 479 Bogan Road QUAMBY BROOK   TAS   7304

NORTHERN MIDLANDS SPORTING CLAYS Inc.   A MEMBER BODY OF TASMANIAN FIELD & GAME ASSOCIATION Inc.                                                                   ABN 39 229 595 472