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SRA-ANZ Registration Form
Note: All applications will be thoroughly reviewed and information verified before Membership is approved,
Member Numbers will be issued afterwards.
Please be sure to double check your information before pushing the "Submit" button.
If you encounter problems with this form, please notify us by email: sra@aussiebeadmakers.com

All fields marked with an * are required:

Name*

Address*

City*

State*

Post Code*

Phone Number*
(Landline preferred)

Email*

No FREEMail Accounts please! eg: Hotmail, etc.

Website URL

Ebay ID

Other Venues
Where else can people find your goods?

Thank you for your interest!

Logo Design Compliments of:

Kathleen Moon - Katzeye Jewellery

WebSite Design Compliments of:
Barbara Robinson - BJAR Beads

Australian Glass Beadmaker's Guild

Name*
Address*
City*
State*
Post Code*
Phone Number*	(Landline preferred)
Email*	No FREEMail Accounts please! eg: Hotmail, etc.
Website URL
Ebay ID
Other Venues	Where else can people find your goods?