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Perth Modernian Society Membership Form
Roberts Road Subiaco WA 6008
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Cheque for $100 mailed to PMS at Above Address:
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Year Attended PMS Yr1(8):
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Year Attended PMS Yr3(10):
Year Attended PMS Yr4(11):
Year Attended PMS Yr5(12):
Years on Staff 1st Appointment:
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Years on Staff 3rd Appointment:
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