MEMBERSHIP APPLICATION FORM
Please print and complete this form and return with payment to the above address.
* Full Year Ordinary Membership - within Australia - 1 person or organization
(full year from 1st April to 31st March) $35.00………………
* (or) Half Year Ordinary Membership – within Australia – 1 person or organization
(half year from 1st October to 31st March) $20.00 ……………….
* Student – full time student in Australia – full year only $25.00 ………………..
(please supply details – e.g. photocopy of student card)
Extra Persons – each $2.00 ………………..
(living at same address and not requiring separate publications)
* Ordinary Membership – Overseas (full year) A$65.00 ...……............
TOTAL .............……....
Cheques/Money Orders should be made payable to "S.G.A.P. (Qld.Region)Inc."
DO NOT SEND CASH IN THE MAIL.
PLEASE NOTE: You may also join one (or more) of our Branches – this is an OPTIONAL ADDITION to Region Membership and Branch fees MUST be paid direct to the Branch(es) concerned. Contact your local Branch for details.
TITLE (Mr/Mrs/Miss/etc) .........…. FIRST NAME/S ................................................................
LAST NAME .........................................................................................................................
EXTRA PERSON(S) NAME(S)………………………………………………………………………………
POSTAL ADDRESS ............................................................................................ Postcode .......
HOME ADDRESS (if different).............................................................................. Postcode .......
TELEPHONE NO. .................................................(home) ................................................(work)
EMAIL ADDRESS ................................................................................................................
I agree to abide by the Constitution and by-laws of the Society.
YOUR SIGNATURE ...................................................
*The *d items include a new membership fee of $5. Renewals are Full: $30, Student: $20, Overseas: $60.
Please also print and complete Page 2