CANBERRA PHOTOGRAPHIC SOCIETY (INCORPORATED)
MEMBERSHIP APPLICATION
Please print out this form, fill
out, sign and submit to the treasurer at a meeting;
or post with subscription to
GPO Box 857
Canberra ACT 2601
I/We apply for a new membership membership renewal
for
Individual($110) Family($160) Student
/ concession($50)
NOTE : Membership at the concession
rate is only available to full time students and Australian disability
or age pensioners. Proof of eligibility in the form of a valid
student card or Australian Government Pensioner Concession Card
is required.
of the Canberra Photographic Society (Incorporated)
and agree to abide by the constitution and rules of the Society.
Mr Mrs
Ms Dr Other[please specify]
SurnameGiven
Name(s) .
Address:
Street
Suburb
City Postcode
Telephone Number (Work) (Home) .
Membership fee of $due.
Date
Please subscribe my email address to "Photon"
the Canberra Photographic Society's email list so that I will
receive up to date info about meetings, activities and about
photographic events around the region. My email address will
not be traded, sold or passed on to any other organisations or
individuals.
Email address for Photon:
Email address for contact if different from
above:
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