Membership Application / Renewal Step 1 of 3 33% LinkedInThis field is for validation purposes and should be left unchanged.Membership Application / RenewalIf joining after 1 January, fee is $5 + 50% of relevant category.Application Type(Required) New Membership Renewal Membership numberNew memberships include a $5 joining fee.Membership Category(Required) Adult – $55 Pensioner – $36.50 Distance – $36.50 Junior / Student – $6 Your Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your PhoneDate of Birth(Required) Day Month Year Your Email Address(Required) Enter Email Confirm Email Emergency Contact(Required) Name Do you suffer from any medical condition you wish to disclose? Yes No N/A Medical DetailsName badge required?Please note – $15 charge if required Yes No N/A Preferred Badge NameVolunteer Interest Committee Social Media Graphic Design Other Select AllVolunteer further information Are you happy for your contact details shared with other memebers Yes No Facebook / Publication Guidelines(Required)The purpose of Alice Springs Quilting Club Inc (the Club) is ● to share the enjoyment of quilting ● to promote and exchange ideas among those interested in or engaged in quilting ● to share and demonstrate methods and techniques of creative quilting and to inspire personal achievements 1. Some members of Alice Springs Quilting Club Executive will make up the Admin of our Facebook and website pages. 2. The Club Facebook page will be used to promote and share club events. Followers of the Club Facebook page can post photos of their own work or relevant quilting images and links. Links to businesses or sites must be relevant to the Club. Spam will be deleted by Admin. 3. By allowing the publication of your quilting item on the internet or in any publication, you may be prevented from entering that item in a judged exhibition. 4. Admin can make amendments to posts, or delete posts, that do not adhere to the club’s purpose, or are deemed inappropriate. It is considered impolite to repost or draw attention to the fact your comment has been deleted. Please contact Admin directly if you would like to find out why your post or comment has been amended or deleted. 5. Posts on the Club Facebook page should be treated with mutual respect, add valuable discussion to conversations and adhere to the club’s purpose. Be friendly, be fair and use common sense. Be aware that some members may not choose to be included in photos. Please ask first before posting. 6. Followers of the Club Facebook page are limited to a maximum of 5 posts per person per day. I have read and agree to the Facebook / Publication Guidelines.Do you consent to photos of you or your work being used in club publications, on the website, or on social media? Yes No Declaration / Membership Agreement(Required) I apply to become a member / renew my membership of Alice Springs Quilting Club Inc. and agree to be bound by the rules of the Association.Payment can be made by Direct Deposit: Alice Springs Quilting Club Inc BSB: 633-000 Account Number: 134 079 656 Reference: Your Name + MembershipFor any membership enquiries please contact: treasurer.asqc@gmail.com
