To join:- download this application form ( in green) into Word.-
THEN SEND THIS PART AS A COMPLETED FORM TO THE SECRETARY
Belle Moore
email bellem@westnet.com.au OR
fax 9622 5275
I /We …………………………………………………wish to apply for Membership of
Earth Solutions-Avon Valley Inc and enclose the
Annual Membership Fee of $ ………. (SEE DETAILS ON THE RIGHT)
To The President/Secretary, PO Box 73, Northam 6401
NAME………………………………………………………………………….
ADDRESS………………………………………………………………………
TELEPHONE/S…………………………………………………………………
EMAIL ADDRESS……………………………………………………………..
SPECIAL INTERESTS…………………………………………………………
SIGNED…………………………………………………………………………. |
ANNUAL MEMBERSHIP FEES
Adult (18 years of age and over)........ $10.00
Pensioner.............................................
$10.00
Child..................................................... $ 5.00
Banking Details for EFT Payments.
Name of Account
Earth Solutions-Avon Valley Inc
BSB 016780
ACCOUNT No. 2022 79951 |