St. Kevin’s Amateur Athletic Club

2006 Membership Form

Name:

 

Date of birth:

 

Address:

 

Email:

 

Phone Ah:

 

Bh:

 

Mobile:

 

If at school, what year are you in ?

 

Tick the appropriate box (tick only ONE category, and singlet if necessary):

Open

·        APSOC Old Collegians events only

􀀀 $75.00

 

·        APSOC Old Collegians events & Athletics Victoria events

􀀀 $95.00

 

·        Athletics Victoria Events only ( Winter and Summer )

􀀀 $65.00

 

·        Athletics Victoria Events only ( Summer only )

􀀀 $45.00

Open Students

·        APSOC Old Collegians events only

􀀀 $60.00

 

·        APSOC Old Collegians events & Athletics Victoria events

􀀀 $80.00

 

·        Athletics Victoria Events only ( Winter and Summer )

􀀀 $50.00

 

·        Athletics Victoria Events only ( Summer only )

􀀀 $30.00

School Student (U16-18)

·        APSOC Old Collegians events only

􀀀 Free

 

·        APSOC Old Collegians events & Athletics Victoria events

􀀀 $30.00

 

·        Athletics Victoria Events only ( Winter and / or Summer )

􀀀 $30.00

School Student (U14 )

·        All Events ( APSOC and Athletics Victoria )

􀀀 Free

Life Members

·        APSOC Old Collegians events only

􀀀 $30.00

 

·        APSOC Old Collegians events & AV events

􀀀 $50.00

 

·        Athletics Victoria events only ( Winter and / or Summer)

􀀀 Free

SKAAC Singlet Top

·        Small, Medium, Large or Extra Large

􀀀 $40.00

·        All members should pay the appropriate fees before they compete.

·        Members competing in AV events will need to fill out the necessary Athletics Victoria form. Please note that the above fees do not incorporate the Athletics Victoria fees.

·        The date for determination of Underage competitors is 31/12/2006

Amount due

Signature

$

 

Please direct debit fees into SKAAC account (063101 00900765 )* or make cheque out to SKAAC and send to:

Dino Imbriano,

SKAAC Treasurer,

12 Cronus Crt,

Eltham VIC 3095

 

Note: If direct debiting into SKAAC account, clearly state the name of the athlete and club fees in the deposit description ( Eg J.Smith – Club Fees )