Join The Lavoisier Group


Please print off and complete the following form and then post it to us at the address below.
(Printable MS-Word version)

I, .........................................................................................................................

of ........................................................................................................................

Tel: .....................................................................................

Fax: .....................................................................................

E-mail: .................................................................................

Occupation: ..........................................................................

desire to become a member of The Lavoisier Group

In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force.


Signature of Applicant:.....................................................

Date:..............................



I, .............................................................................................,

a member of The Lavoisier Group, nominate the applicant for membership of the Group.

Signature of Proposer:.....................................................

Date:..............................


I, .............................................................................................,

a member of The Lavoisier Group, second the applicant for membership of the Group.

Signature of Seconder:.....................................................

Date:..............................



Cheque enclosed for $ ........................................... (Annual Subs $50)

Please make your cheque payable to 'The Lavoisier Group, Inc'


Please forward cheque and form to:

The Lavoisier Group,
P.O. Box 424 Collins Street West,
MELBOURNE VIC 8007



Lavoisier the Man
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