I/We ................................................................ would
like to:
- join
Nature and Society Forum and agree with the principles and working
methods [ ]
- renew
membership [ ]
- make
a tax deductable donation to Nature and Society Forum of $.....................
- find
out more about: .......................................................................................
My/our
relevant interests are: ..................................................................................
Signature/s........................................................
Date: ...........................................
Address: ...............................................................................................................
....................................................................... Post code: .....................................
E-mail: ............................................................ Telephone: ....................................
(New members of Nature and Society Forum receive a free copy of Our Place in Nature)
Membership fees (Australian dollars)
Annual
membership
2008-09
|
Standard
|
$55 |
| Concession
(students, govt pensioners) |
$22 |
| Corporate |
$110 |
| Life
membership |
|
$550 |
Payment
Cheque
payable to Nature and Society Forum
Inc.
| Card |
[
] Visa |
[
] Mastercard |
l__l__l__l__l l__l__l__l__l l__l__l__l__l l__l__l__l__l
Cardholder: ................................................................ Expiry
date ........../.........
Signature: .......................................................................................................
Membership fee: $................................
Donation (tax deductable): $...................
Total paid: $........................................
Please
mail completed form with payment
or
credit
card details to
Nature and Society Forum,
GPO Box 11, Canberra ACT 2601
or fax to 02-6125 1756
|