TASMANIAN CRICKET UMPIRES & SCORERS ASSOCIATION INC.
ABN: 31 797 765 719
Administrator: Graeme Hamley Postal Address
Ph: 6228 2582 P.O. Box 368
Lenah Valley Tas 7008
E-mail –
MEMBERSHIP APPLICATION OR RENEWAL – SEASON 2014/15
(Strike out category not applicable)
NAME: DATE OF BIRTH:
(Please Print) (Mandatory for “My Cricket” Registration)
ADDRESS: (Number & Street)
(Suburb) Postcode:
PHONE: / /
(HOME) (WORK) (MOBILE)
E-MAIL ADDRESS:
MEMBERSHIP (please tick)
UMPIRE MEMBER SCORER MEMBER
MATCH PAYMENT DETAILS
ALL UMPIRES ARE PAID FORTNIGHTLY BY E.F.T. FROM CRICKET TASMANIA
ALL SCORERS ARE PAID ANNUALLY BY E.F.T. FROM CRICKET TASMANIA
BANK DETAILS (for E.F.T. payments):
BSB (6 digits) ______ACCOUNT NUMBER
(IF BSB & ACCOUNT DETAILS ARE THE SAME AS LAST SEASON, PLEASE TICK HERE)
GST DECLARATION: The supply of my service to officiate as an umpire/scorer of Cricket in Tasmania is in my capacity as an individual and is made in the course of an activity that is a private recreational pursuit or hobby, therefore I am not quoting an ABN and no amount should be withheld from payment.
SUBSCRIPTION DEDUCTION AUTHORITY
I hereby authorise the deduction of the Association Annual Subscription of $40.00 (Umpire) and $20.00 (Scorer) from my match payments. YES / NO
Payroll Deductions are the Association’s preferred form of payment of subscriptions and other purchases during the season. For other preferences, contact the Association Administrator.
SIGNED: DATE:
TCUSA USE ONLY:
REGISTRATION ACCEPTED / REJECTED DATE:______