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Membership application
Persons name
*
First name
Last name
Mobile
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Email address
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I can volunteer
Please let us know if you can volunteer in any capacity
No
Yes
Skills & knowledge
Please let us know if you have any skills or knowledge that may help our group.
Other person (Same household)
First name
Last name
Mobile
Email address
I can volunteer
No
Yes
Skills & knowledge
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Address
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Address line 1
Address line 2
City/Suburb
State/Territory
Postcode
All individual members except concession card holders
Quantity
Price
Total
Individual membership (1 year)
$35.00
$
Quantity
Price
Total
Individual membership (3 years)
$95.00
$
One adult and their partner and all children from birth until they turn 18
Quantity
Price
Total
Family membership (1 year)
$55.00
$
Quantity
Price
Total
Family membership (3 years)
$150.00
$
All individuals holding a seniors card
Quantity
Price
Total
Senior membership (1 year)
$30.00
$
Quantity
Price
Total
Senior membership (3 years)
$80.00
$
Any individual who is studying full-time, or an individual who holds a current Australian or WA Government concession or healthcare card. Note: 3 years memberships not available with this category.
Quantity
Price
Total
Student/Concession membership (1 year)
$30.00
$
Total amount
$
Payment
*
Credit/Debit card
Bank deposit (General)
Make deposit to account
633000 162355705
Please check the highlighted fields
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