The Amalgamated Prospectors and Leaseholders Association of WA (Inc.)

APPLICATION FOR MEMBERSHIP OF BRANCHES AND AFFILIATED ASSOCIATIONS.


Name...................................................................................................

Address................................................................................................ 

Post Code............................ 

Phone..................................................... 

Miners Right No........................................ 
Type of prospecting/Mining (e.g. Underground, Metal Detecting, Alluvial Mining, Recreational or Full Time etc)............................................................................... 
I would like to join the ................................................................branch.


Please indicate which branch you wish to join:
(.........) Eastern Goldfields Prospectors Association
(.........) Metropolitan Prospectors Association

Note: Please print page, fill out and send it to the APLA secretary - see below.
Please make your payment to APLA Secretary, PO Box 2570, Boulder WA 6432
Membership : Single $60, Pensioners $40
Family Membership $100 (Includes 2 adults + 2 children up to 16 years of age)


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