Membership and Donation

Complete the form below to join, renew &/or donate.

    1. About You

    Title

    Your First Name

    Your Last Name

    For Couples Membership

    Your Email

    Street/PO Box

    Suburb

    PostCode

    State/Territory

    Phone

    Year of Birth (optional)

    2. Type of membership

    Type of Membership

    *concession rates apply to means-tested pensioners

    Are you
    Renewing your membershipA New memberMaking a donation

    3. Payment Method

    Select your payment method
    Direct Bank TransferCheque
    Date of Bank Transfer

    Bank Details:
    The email acknowledging your lodgment of this form will contain details of our bank account

    Cheques to:
    PO Box 55
    Waramanga ACT 2611

    4. Lodge your completed form

    Need a paper based form?

    Click here to download a paper form.

    Click here to make a Bequest