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.
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_____
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: