Membership Form (2022/2024)

Name (Applicant)

I hereby apply for the Telangan Association of Queensland Membership and agree to be governed by the TAQLD Constitution, Bylaws and Code of Ethics.

First Name

Last Name

What Membership are you opting for:

Life (family) - $150

Yearly(family) - $20

Single Entry - $10

Email (Applicant)

Communication

Do you wish to receive emails and other communication from Telangana Association of Queensland?

Yes

No

Phone (Applicant)

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Family Details:

Declaration:

I declare that the above information is true and complete to the best of my knowledge. I will abide by the rules of the Association, and I understand that false and misleading information in the application may result in cancellation of membership.

Signed by

First Name

Last Name

Date

MM

DD

YYYY

Membership fee can be deposited into the below Telangana Association of Queensland Bank Account with your full name:

Account Name: Brisbane Telangana Association Inc.

Membership Form (2022/2024)

BSB: 064 000 Account Number: 1389 9409