Membership Form – CommonAge

CommonAge Membership Form

COMMONAGE ASSOCIATION FOR THE AGEING – ABN # 51 600 618 602 REGISTERED IN AUSTRALIA

AS A NOT FOR PROFIT

NAME

FIRM / COMPANY NAME

DATE OF BIRTH

FULL ADDRESS

COUNTRY

CONTACT NUMBER

EMAIL ID

LAUGUAGE

PROFESSIONAL QUALIFICATION

I consent to being a Member of CommonAge Association for the Ageing and the above information furnished by me is correct.

I promise to hold NO personal liability against CommonAge or will NOT have any share in the assets’ or finances of CommonAge.