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Membership form

Welcome to the online QSAM membership application section. To apply for membership to QSAM, please complete the form below. Payment instructions will be given after you send the form. Fees are $40 (group) and $15 (individual) and are current until 30 June each year. We look forward to your participation and involvement in QSAM's activities.

Name: *
Email: *
Your sport:
Club:
Position in your club:
Street address:
Suburb and postcode:
Telephone:
Membership type:
Security Code:
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