Subscribers
Application Form
Current Rates Are
Family $60.00 Single $30.00
SUBSCRIBERS APPLICATION FORM
(Please return this portion with payment)
| Name: | __________________________________________ |
| Address: | ______________________________________ ______________________________________ ______________________________________ |
| Phone Number | ( ___ )____________ |
| Type of Subscriber | Family [ ] Single [ ] (Please Tick) |
| Donation | $_____________ |
| Amount Enclosed | $_____________ |
Please make your cheque payable to:
BALLARAT GOSPEL RADIO INC.
Po Box 51 Wendouree Victoria 3355
Last Updated: Jan 2011