The Annual Subscription Rates are:
Please complete the form below to confirm your membership details and return it with your subscription payment/payment advice (e.g. Bankcard, Mastercard or Visa). This will allow us to update our records where necessary. Once again, please note that overseas members must include the relevant airmail postal costs with their subscription.
Printable .pdf version of this form - CLICK HERE
| Given name(s): | Surname: | Mrs / Miss / Ms / Mr / Dr | |
| Address: | . . | Optional - Would you prefer Bromeletter delivered by email ? Please circle . . YES or NO . . | |
| Contact: | email : | Business Phone: | Private Phone: |
| Membership : | Joining Fee (new members only) A$5.00 ( ) | Membership A$25 per year ( ) | |
| Asia/Pacific Airmail + A$15.00 ( ) | Rest of World Airmail + A$20 ( ) | ||
| Payment : | Cheque ( ) | Overseas Draft ( ) | Cash ( ) |
| (Please tick) | Bankcard ( ) | MasterCard ( ) | VISA card ( ) |
| Postal Order ( ) | Other : | ||
| Card Details : | Cardholder name: | Address: . | |
| Card number: | Expiry: . | ||
| Signature : . | |||
| NAME USE AUTHORISATION: Under the provisions of the Privacy Act, recently passed by the Federal Government, use of names and references to private details, such as illness, holidays, birthdays and items of a similar nature, such as those contained in Members' Update, may only be published with the written permission of the person concerned. This is a government requirement, not this Society's. Do you agree to having such personal information included in the Bromeletter? |
| Yes. _____ | No. _____ | Signature._______________________________ |