Central Otago REAP - Membership Form

Central Otago REAP - MEMBERSHIP FORM

Please complete and print this form, and then send it with payment to :

Central Otago Reap
17a Brandon St
Alexandra

I/We would like to apply for membership of Central Otago REAP Incorporated.

Name:

Contact Person (if group):

Address:

Please find enclosed annual subscription of:

	$5.00 (Individuals, Playgroups, Kohanga, Course participants)
	$10.00 (Annual Corporate Clubs)
	$10.00 (Annual School)