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Armed Services Assistance Centre (ASAC) Australia
Providing free assistance with welfare, pensions, compensation and entitlements
to Veterans, serving and ex-members of the Australian Defence Force and their families.

Membership Application Form

Name: _______________________________________________________________
Date of Birth: _______________________________________________________________
Address: _______________________________________________________________
_______________________________________________________________
Phone/Fax: _______________________________________________________________
Mobile: _______________________________________________________________
Email: _______________________________________________________________
Marital Status: _______________________________________________________________
Next of Kin: _______________________________________________________________
Service Arm: _______________________________________________________________
Period of Service: _______________________________________________________________
Occupation: _______________________________________________________________
Comments: _______________________________________________________________
_______________________________________________________________


Your $25 membership fee entitles you to receive an ASAC Membership Card; 4 Newsletters per year;
and invitations to attend any ASAC functions. Membership fees benefit serving and ex-serving members
of the Armed Forces in their dealings with Government Departments in relation to Entitlement claims.

Yours Sincerely,
Noel Payne
President, ASAC Australia

Brisbane: S.E.D RSL Building, First Floor, 42 Oxlade Drive, New Farm Q 4005
Ph: 07 3358 6522 Fax: 07 3358 6433 E-mail: info@asacaustralia.com
Website: www.asacaustralia.com