Debit Tax Association

Membership Application Form


Surname: . . . . . . . . . . .Given Names: . . . . . . . . . . . . .   


Address: . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .   


City: . . . . . . . . . . . . State: . . . . . . . Post Code: . . . . .  

Telephone

Home: . . . . . . . . . . . . Business: . . . . . . . . . . . . . . . . 


Facsimile: . . . . . . . . .  Mobile: . . . . . . . . . . . . . . . . .  


E-mail: . . . . . . . . . . . Photocopier:  yes / no 


I, . . . . . . . . . . . . . . . . . . wish to become a member of the
Debit Tax Association. I will endeavour to promote the Debit Tax concept
as explained by the Debit Tax Association. 


Signature: . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . .

Membership Payment: 
          Single -  $10.00 � 
          Dual -    $15.00 � 
          Donation  $__.__ � 

Please make cheques, postal orders, etc., payable to 'Debit Tax Concept'.
Membership renewable yearly from date of application acceptance. 

Forward To:- 
          Secretary 
          Debit Tax Association 
          P.O. Box 61 
          Mt Crosby News 
          Mt Crosby Qld 4306

Can You Help??

We are endeavouring to reach as many people as possible with the
Debit Tax concept. You can help by passing on Debit Tax information
to your friends and family. Through this concept we hope to achieve
a tax reform that would benefit ALL Australians.

We also need people for various activities such as Area Co-ordinators,
mail-outs, document re-production etc. If you feel you can help us
promote the Debit Tax we would be pleased to hear from you.
Please indicate in the space below how you can assist.