Johannesburg Centre, Astronomical Society of Southern Africa

 

Astronomical Society of Southern Africa
Johannesburg Centre
2004 Committee Ballot Form

There are ten portfolios required for the 2004/2005 Committee. Place a check mark beside a minimum of 5, maximum 10 candidate names.  Post your ballot form to Box 412323 Craighall, 2024 or bring it to the 2004 AGM Meeting

Atze Herder

  

Brian Fraser

  

Bruce Dickson

  

Chris Stewart

  

Chris Penberthy

  

Dave Gordon

  

Dave Hughes

  

Evan Dembskey

  

Jerome Jooste

  

Lerika Cross

  

Marienne Botha

  

Pam Sutton

  

Sharon Tait

  

 

Astronomical Society of Southern Africa
Johannesburg Centre
Membership Renewal Form

Kindly complete this form, detach it and return it, together with your payment to Box 412323 Craighall, 2024. Direct deposits may be made to   “ASSA Johannesburg Centre”,  Nedbank, Account # 1921013761, Branch Code 192142. Please fax your deposit slip to the Membership Secretary, 011 793-6787 or email chris@penberthy.co.za with your payment receipt.

Full Name:

Membership number______

Postal Address:

 

 

Code

Physical Address:

 

 

Code

Tel (W)

Tel (H)

Fax

Cell

Email Address

 

2004/2005 Membership Subs (please tick one)

Normal member annual subs

R125-00

Family annual subs

R150-00

Minors, Pensioners, Students

R  62-50

Voluntary Donation

  R

Total Enclosed:

  R

 

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