AUSTRALIAN BIRD STUDY ASSOCIATION Inc.
APPLICATION FOR MEMBERSHIP

Please print this form and send completed form with your subscription to:

The Secretary, ABSA Inc, PO Box A313, Sydney South, NSW 1235

Title    Family Name    Given Name 

Address    P/code

Phone(H)    Phone(W)

FAX    e-mail 

Do you wish to be sent a copy of the Constitution of the Association? yes / no

Subscriptions (per annum) for calender year 2007:

MEMBERSHIP TYPE - Please circle one:

Amt ($AUS)

 Includes GST of:

Full

$55.00

$5.00

Concessional  (under 18yrs of age; pension card holders; f/t student)

$38.50

$3.50

Household 

$66.00

$6.00

Outside Australia - full

$60.00

-

Outside Australia - concessional (under 18yrs of age; pension card holders; f/t student)

$45.00

-

Outside Australia - Household

$70.00

-

Institutional (Aust.)

$77.00

$7.00

Institutional - outside Australia

$80.00

-

Subscriptions are payable in advance and become due on the 1st January each year.  Please indicate below which year you are paying for.  People joining late in any year will be sent the full journal for that year.

Bankcard / Mastercard / Visa (please circle)

  • Cardholder's name 
  • Card number          
  • Expiry date    Signature  

or
I enclose $  as my subscription.

This payment is for year(s) beginning January (2002, 2003 etc)

SignatureDate This is a New subscription or Renewal(please tick).

For Junior Members only: Date of birth

Cheques should be made payable to the Australian Bird Study Association and Money Orders made payable at the GPO Sydney.