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  WESLEY COLLEGE (COLOMBO) OLD BOYS’ UNION

Subscription Payment Slip

 (Annual Subscription - $15 ,  Pensioners - $10  *Seniors  - Voluntary)

         Given Names: ............................................................................

         Surname: ....................................................................................

         Address: ......................................................................................

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

         Email Address (optional): ...........................................................

         Subscriptions for year/s: .............................................................

         Total AUS $: ...................................

         Date: ................................................

         Cheques to be made payable to "WCOBU Australia"

         *Seniors (over 70 years of age) are to inform the Treasurer of their age to qualify.

         Postal Address: 

         Treasurer,

         WCOBU Australia,

         Box 123 Glenway MDC,

         Mulgrave,

         Victoria 3170,

         Australia.