Receipt no Fee must accompany form This form should be completed in BLACK or BLUE ink and in BLOCK LETTERS. See information sheet Association details ~~ — __ | Incorporation number woy| Qlol719 slat? name [Pus t@ALIAN VACC MATION SkePTics NETWORK | incomorated ‘The principal activity of the association is X|(cross 1 box only) i Aged carefesplecarehone ere IE, Eaveatorlemploymantvaiingheseareh | |S. Ralgous P- Atseuturemeraryheriage [s- ErvironnentRortcureanimal prelecion | |'0, Seda sanvorslconmunly atodaion I. Business & professional assodaton F-Legaleaavacacy senecas i Sparing Child eae services [8 Personal rverestnobby groupizocal group | [12 Ober ABN (Hany) aleloloi>lololal9jal3 (Oats arearentRUBle ofear __ Name [ MERYe Soe y Has the public officer changed? Yes J No Has the official address changed? Yes No. ttyou answored "Yost hero both quests, you are required to lg @ Form Ao, Notice of appointment of pubic PrOGALo.) ste [NSD Postcode [OY 77 (including personal information) supplied in this form for the purposes of the inclusion in a régister maintained under that Aét which is open to public