Form Cac/it 1 - Incorporated Trustees Application Form Page 4

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PARTICULARS OF SECRETARY
Surname:
Other Names:
Accreditation No. (if applicable)
Address (In case of Corporate the
Registered or Principal Address)
City:
State:
P. O. Box
E-mail
Tel. No.
THE IMPRESSION OF THE COMMON SEAL
ENCLOSURES
YES
NO
(a) Copy of the Relevant Minutes of the Meeting whereat the Trustees were appointed
and Special Clause Rule adopted for incorporation into the Constitution.
(b) Details of current or past affiliation with any existing organisation/association
________________________________
________________________________
Signature of Chairman
Signature of Secretary
________________________________
________________________________
Name of Chairman & Tel. No.
Name of Secretary & Tel. No.
Note:
If there is insufficient space on the form to provide any information required, please attach a seperate sheet containing the information set out in the
prescribed form
Presented for filing by:
Name: ____________________________________________ Accreditation No. (if applicable): ______________________________
Address: ____________________________________________________________________________________________________
Tel. No. & E-mail: _______________________________________ Signature & Date: _____________________________________

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