Forms

BARRABOOL HILLS LANDCARE GROUP MEMBERSHIP FORM

please tick one    [ ] NEW MEMBER APPLICATION

[ ] MEMBERSHIP RENEWAL       

Membership Subscription is  $15.00 per family per year. Renewal is due on 1 July.

Please consider electronic payment if you are renewing your subscription (and your details are unchanged).

Forward a cheque to the Treasurer, or pay by direct credit. 

NAME_________________________________________________________________________________________________

POSTAL ADDRESS_____________________________________________________________________________________________

PHYSICAL ADDRESS (If different to above)_____________________________________________________________________

MOBILE PHONE   _______________________________                            (useful  for sms alerts)

EMAIL_______________________________________________________________      (useful  for forwarding minutes  of Group meetings)

SUBSCRIPTION:          ___I yr $15.00       ___2yrs $30.00        ___3yrs $45.00        ___Other x $15.00

SIGNATURE_____________________________________     Number of people covered by this membership_____

PAYMENT OPTIONS:

By Cheque:

Please make cheques payable to:  Barrabool Hills Landcare Group, and post with this form to:

BHLG Treasurer, 1270 Barrabool Road Gnarwarre Vic. 3221

By Direct Deposit:

Bank Account details:  Barrabool Hills Landcare Group,

Bendigo Bank BSB:   633 000     Account Number:   163 791 817                                                                      

            Please include your surname and initials as a reference & email your application form to:

                                           barraboolhillslandcare@gmail.com