Join the NTMBC today!

Northern Territory Multiple Birth Club (NTMBC)

      Twins                 Triplets                   Quads                    Higher

Date:               /           /	New Application or Renewal (please circle)
Family Name:                         -----------------------------------	First Name:                    -----------------------------------------------
	Partner’s Name:                             ----------------------------------------
Postal Address:                            ---------------------------------------------------------------------------------------------------
Residential Address (if different):                                                       -----------------------------------------------------------------------------
Telephone Number:                                  ----------------------------	Mobile Number:                          ------------------------------------------
Email Address:                            ---------------------------------------------------------------------------------------------------
Are you interested in receiving information regarding club events via email, including newsletters?		Yes/ No (please circle)
Do you give permission for the NTMBC to print your details in the monthly club newsletter?  This includes child(rens) birthday and social photos/articles?		Yes/ No (please circle)

Name of all children.

1
	(Given Name)	(Surname)	(Date of Birth)	M/F
2
3
4
5
6

Membership is open to all parents or carers of multiple birth children.  Full membership entitles the holder to access the library, hire equipment, vote at committee meetings and receive discounts at specific local outlets.  Associate membership is available to any other interested party who would like to receive the newsletter.  Fees are payable within 8 weeks of joining and renewals are due 1^st March each year.  Fees may be paid in two six monthly installments each year.  Any members joining after September 1^st pay half the yearly rates.  Only financial members will receive a copy of the newsletter.

Annual Fee Due 1^st March

Half annual fee payable if joining from 1^st September