Join

Nb: Do not attempt to type into this form, as the typing will be lost when you go to print it out. Use the print button at right to print the form, and fill in by hand. Thank you.

APPLICATION FOR MEMBERSHIP

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

The Secretary, ABSA Inc, PO Box 1867, Penrith BC, NSW 2751

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) from 1 January 2011:

MEMBERSHIP TYPE - Please circle one:

Amt ($AUS)

Includes GST of:

Full

$60.00

$5.45

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

$40.00

$3.63

Household

$75.00

$6.82

Outside Australia - full

$70.00

-

Outside Australia - Household

$80.00

-

Institution (Aust.)

$90.00

$8.18

Institutional - outside Australia

$100.00

-

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 (2012, 2013 etc)

SignatureDate  New subscription (tick)or Renewal(please tick). For Junior Members only: Date of birth

Is this a gift membership? Name of giver