BIRDS SA

The South Australian Ornithological Association Inc.

ABN: 76 339 976 789

MEMBERSHIP APPLICATION

 (This form can be filled out on-line. Please click on which category you are applying for.)

PRIMARY MEMBER

FAMILY NAME

GIVEN NAMES

OTHER MEMBERS

FAMILY NAME

GIVEN NAMES

 

FAMILY NAME

GIVEN NAMES

 

ADDRESS:

 

 

TELEPHONE:

EMAIL ADDRESS:

 
Payment may be made by cash (at a General Meeting); by sending a cheque or money order to the address below;
or by direct credit to our account (details below).

SUBSCRIPTION RATES FOR 2010

Single Membership:

$45.00

Family/household Membership:

$55.00

Concessional rates:

Single Membership:

$40.00

Family/household Membership:

$50.00

Student (full time students under 25 years of age)

$10.00

Donations to the Birds SA Conservation Fund
   (Donations of $2 and over are Tax Deductible)

TOTAL:  $

DIRECT CREDIT details:
BSB Number  610 101  ACCOUNT Number  0711135384  REFERENCE  Your family name plus postcode

Return to:

The Treasurer
Birds SA
c/- The South Australian Museum
North Terrace
Adelaide, South Australia, 5000

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