Surname:_____________________First Names:_______________________________________
Telephone Number:_________________________
Fax Number:         _________________________
Email:_________________________________________________________________________ Occupation:____________________________________________________________________

1. I hereby apply to be admitted as a member of the Zig Zag Railway Co-op Ltd. and to be allocated ________ shares therein. (Minimum 3 shares)

2. If this application be approved and the shares as aforesaid be allotted to me, I agree to pay all charges required by the Society, a list of which charges has been supplied to me below, and I agree to be bound by the rules of the Society and by any alteration thereof registed in accordance with the Co-operatives Act 1992.

3. * I am over the age of eighteen years or
    * I am under the age of eighteen years
having been born on the _________day of ________________19___
* Strike out the words which are not applicable

All prices in Australian Dollars. Members residing outside Australia do not pay GST (Goods and Services Tax)(10%).


3 Shares at $1.00 each: (No GST) 
  $3.00 _______
$40.00 _______
Dependent Child at the same address as an adult member: $12.00 _______
Youth, under 18,no adult member at same address: $30.00 _______
Donation: (No GST on Donations)            

Total: _______

Applicant's Signature: _____________________________________

Witness' Signature:_______________________________________
Date:_____________________day of ______________20________

The rules of the Co-op together with a copy of the last annual report are available for inspection by prospective members at the registered office.

Payment may be made by cheque, money order, or credit card (Please complete details below).
Type of Card: Mastercard: ______ Visa: ______
Card Number:__________________________________________
Valid From: _________/_________  To:__________/___________

Send to: Zig Zag Railway Co-op Ltd., P.O. Box 1, Lithgow, NSW 2790, Australia or
Fax: +61 (0)2 6355 2954

Updated 16 May 2007