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The Secretary
Retired Police Association of NSW Inc.
PO Box 354
WINGHAM
NSW 2429
Dear Sir,
I wish to become a member of
the Retired Police Association of NSW Inc.
* My annual membership fee of $18.20 is enclosed.
OR
* I have completed the ‘Authority to Deduct’ from my
Police Superannuation.
OR
* I have completed
the ‘Authority to Deduct’ from my Police Credit Union account.
My particulars are as
follows:
Surname:
________________________________________________________________
First Names:
________________________________________________________________
Address:
________________________________________________________________
Suburb:
______________________________________ Postcode: _______________
Phone No:
___________________________________ Mobile: _____________________
D.O.B.:
______________________________________
Former Reg’d No:
______________________ Date of Discharge: ______________________
Partner:
________________________________________________________________
E-mail:
________________________________________________________________
( * Delete words not
applicable )
Signature:
_____________________________________ Date: _____________________
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