OFU Student Membership Form 2017

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NORTH SYDNEY BOYS’ HIGH SCHOOL

OLD FALCONIANS’ UNION

APPLICATION
FOR STUDENT MEMBERSHIP

Please print all details

Surname ____________________________ Given Name/s __________________________

Preferred Name or Nickname ________________ Years at N.S.B.H.S. _________to________

Address ____________________________________________________________________

Telephone ____ ______________________ Mob __________________________

email_______________________________________________________________________

I am happy to receive all O.F.U. communications by email.

Invite me to join the Falconian on-line communities on Facebook, Twitter, LinkedIn.

Membership Category sought:

Student Life Membership $80 Only valid to 31 December 2017

Five Year to 30 June, 2022 $55

Ten Year to 30 June, 2027 $85

Life Membership $185 Life Membership Certificate $7.50

Cheque payable to Old Falconians’ Union enclosed.

I wish to pay by credit card: Visa Mastercard

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Expiry date ____ / ____ Amount authorised $

Signature _____________________________________ Date / /

Return to: The President, Old Falconians’ Union


49 David Avenue OR email to:
North Ryde N.S.W. 2113 ofu.nsb@gmail.com

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