GOLD COAST CITY JAZZ CLUB Inc. 5 Melaleuca Drive Palm Beach QLD 4221 Website www.gccityjazzclub.com Email gccityjazzclub@gmail.com MEMBERSHIP RENEWAL/APPLICATION to 31st December 2024 SURNAME (Mr / Mrs / Ms)..……………………………………………… FIRST NAME……………………………………………………………… ADDRESS………………………………………………………………………… ……………….…………………………………………………………………..… POST CODE…………………… EMAIL ADDRESS…………………………………………………………….… PHONE NO………………………………………………………… MOBILE PHONE NO………………………………………………………..… MUSICIAN Yes / No Instrument……………………………………… In making application for membership of the Gold Coast City Jazz Club Inc, I agree to abide by the Constitution of the Association. SIGNATURE…………………………………………… DATE…………… |
2024 Annual Subscription (Please mark your selected fee) Membership Adult $25.00 Student Youth (18 – 25) $10.00 Junior Under 18 years $ 5.00 Please return, with payment, to Gold Coast City Jazz Club Inc. 5 Melaleuca Drive Palm Beach QLD 4221 OR Direct Deposit to Heritage Bank BSB 638 070 A/c number 1051 3655 |