APPLICATION FORM

To join, either complete this form, post it to

Tropic Sun Dress Circle
P.O. Box 619
Townsville, Qld 4810

Or Fax (07) 4721 5250

Or Phone (07) 4721 5433 and we will take your credit card and all details over the phone

Name:______________________________________________

Phone:__________________________

Address:_____________________________________________

Post Code:__________

Email address:_______________________________

Please attach a cheque for $50 or complete the credit card details below

Card type: Visa or MasterCard (circle one)

Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Expiry Date _ _ __ / _ _ __

Name on card:_______________________________________

I authorise Tropic Sun to debit the above credit card the sum of $50.00

Signature:___________________________________________

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