APPLICATION FOR MEMBERSHIP

I wish to become a member of the Jane Austen Society of Melbourne Inc. ABN 80 025 064 214

NAME (Dr/Mr/Mrs/Miss/Ms).....................................................................................

Address...................................................................................................

........................................................................................Postcode.................

Telephone Number.....................................

Email.............................................................................................................

Are you happy to received the JASM newsletter by email? Yes/No

In the event of my admission as a member of the Jane Austen Society of Melbourne, I agree to be bound by the rules of the Society for the time being in force.

 

I enclose cheque/cash for $..........................

 

Signature ................................................................................Date ................................................

 

Payment options:

In person by cash or cheque at a meeting. Please try to have the correct money available.

By mail - Please make cheque payable to the Jane Austen Society of Melbourne and send it with this form to: Mrs Deirdre Meredith

Hon Treasurer, JASM,

81 Roy Street,

DONVALE VIC 3111

Direct transfer BSB 633-000 A/c No. 119182335

A/c Name Jane Austen Society of Melbourne

Please ensure you put your name in the reference box and notify the Treasurer of your payment by email to impulse101@optusnet.com.au A signed completed copy of this form should be included in your email.

 

Subscriptions: Ordinary membership - $50.00; Concession - $45.00; Family - $60.00

 

http://www.jasm.org.au