Apply for Membership

First Name*

Surname*

Street Address*

Suburb*

Postcode*

State*
—Please choose an option—ACTNSWNTQLDSATASVICWA

Phone Number

E-mail

I am the child of:

I am the grandchild of:

I am a member of the following descendant group/s:*
Mickey RayAlen 'Witchery' RayGeorge JacobsJonson Murray JacobsKitty RayGeorge 'Docherty' RayRosie JacobsRonald Ray 'Pontius' PilotJimmy JonesAlec Jacobs

I hereby apply for membership of the Boonthamurra Native Title Aboriginal Corporation RNTBC. I declare that I am a Boonthamurra Person, being a descendant of Kangaroo and/or Dick Ray.

I confirm that I am at least 18 years of age, and that the information submitted in this application is true and correct to the best of my knowledge. I understand that any false statements may result in denial or revocation of my membership.