This form should be completed NLT 1 June, prior to the commencement of the new Fraternal Year.
From this form a listing of all staff members and related information for the new Fraternal Year will be created for publication in the State Directory.
A copy of your submission will be emailed to you after being submitted. Retain for your files.
PLEASE ENTER INFORMATION IN THE FORM AS SHOWN AND CHECK FOR ANY ERRORS BEFORE SUBMITTING
Note: Submitted Email Addresses must be Personal Email Addresses
