I, …………………………………………………….

apply for membership of Mayne Junior AFC Inc.

…………………………………………………..(signature here)

I, …………………………………………………………

apply for membership of Mayne Junior AFC Inc.

…………………………………………………..(signature here)

.

Date:        /         /20

Approved:        /         /20

Date:        /         /20

Approved:        /         /20

PAYMENTS RECEIVED:           Payment Type & Date

REGISTRATION   $               In SIGN ON TOT REC      /     /

SOCKS             $                CC  CHQ  CSH     /     /

SHORTS           $               CC  CHQ  CSH     /     /

CHOCOLATES    $                CC  CHQ  CSH     /     /

RAFFLE TICKETS  $                CC  CHQ  CSH     /     / LESS DISCOUNT $ -              CC  CHQ  CSH     /     /    MISCS for          $                 CC  CHQ  CSH     /     /

MISCS for          $                 CC  CHQ  CSH     /     /

MISCS for          $                 CC  CHQ  CSH     /     /

POLO SIZE   [Ordered CIRCLE ~ CROSS & Date when taken]~

YOUTH       6     8      10      12     14    16

MENS         S     M     L     XL     2XL     3XL     4XL     5XL

SOCKS                         SHORTS

BOX #

TICKETS #         ~

SIGNON TOTAL RECEIVED

$            CC  CHQ  CSH

Follow up Required …………………………………….Completed…………/………/

Follow up Required …………………………………….Completed…………/………/                                                                         Follow up Required …………………………………….Completed…………/………/

                                      Entered into Database      /     /     .