41st Infantry Battalion Association Inc

Full Name of member

Street Address incl surburb (No PO Box )

Po Box if applicable

Home Phone

Mobile (you may receive text about meetings and key events)

Email address (for most corro)

CLOSEST Depot (within 30-60mins)

Not Applic - I live more then 60 mins away
Tweed Heads NSW
Lismore NSW
Grafton NSW
Coffs Harbour NSW
Port Macquarie

Please advise which category you fit into

A current serving member of 41st Battalion
A ex member of the 41st Battalion
A spouse or child of a serving /ex memb
A ex service man/woman
Member of the public and interested in joining
Current CSSB pers posted to 41 loc
Current serving member of Defence not 41 Battalion

If a current serving member your current sub unit

A Coy Tweed Heads
BHQ or MS PL Lismore
Grafton
Coffs Harbour
Port Macquarie

If ex 41 Battalion please advise Coy assoc with

If NOT ex 41 with military service please advise UNIT's posted to

Rank upon leaving the military

Length of military service in years (total)

Type of membership requested

Annual membership $20
3 year $50
Life Subscriber $250 once off then $0 annually

Type 0f payment to be made

by PAYPAL once renewal submitted PAY NOW and you will be taken to Cart where you can check out , select Pay without Paypal account
by payment to the assoc bank account details will be advised once renewal form submitted

Comments what would you like see the assoc do more of (your feedback is appreciated)

Disclaimer

I hereby declare the above information to the best of my knowledge is an accurate record of my service, and any disclosure of false information could void my application and or may result in my exclusion from the Association PRIVACY STATEMENT - your information will be used by the association to manage your membership and will not be shared with any person outside the 41st Inf Battalion Association Inc, if a serving member you give permission for this information to be shared with your chain of command or other 41st Battalion /CSSB personnel.