Rural Youth Organisation of Tasmania Inc.
MEMBERSHIP
MEMBERSHIP FORM

 All fields shown with an astrix * are mandatory and must be completed for application to be processed

Name: *
Postal Address: *
Postcode: *
Club:
Subscription: 1 Year ($25 inc GST) 2 Years ($44 inc GST)

 

 

 

 

Contact Details

Phone (h): *
Phone (w):
Phone (m):
Fax:
Email:
Permission to publicise contact details: No Yes
Birthdate * / /
Gender: * Male Female
Status: Single Married
Residence: Farm Residential
Occupation: Student Unemployed
Non-rural (specify)
Farming (type)
Willing to host an exchangee: No Yes
Member Skills, including licenses held: (please list):



Member Interests: (please list):



Please indicate your training interests
Meeting Procedure Handling the Media Advanced Driving
Conflict Resolution Mediation & Negotiation MBTI Teambuilding
Time Management Stress Management Communication Skills
Getting the most out of people Managing Volunteers Customer Service
First Aid/CPR Other (specify)

INFORMATION COLLECTED FOR IN-HOUSE USE ONLY AND FOR THE PREPARATION OF STATISTICS. CONTACT DETAILS ARE NOT DISTRIBUTED TO OTHER USERS AND WILL ONLY BE PRINTED IN THE RURAL YOUTH DIRECTORY WITH YOUR PERMISSION.