|
Ordinary - $25 |
|
|
|
|
|
|
|
Joint - $35 |
|
|
|
|
|
|
|
Concession (pensioner / full student) - $15 |
|
|
|
|
|
|
|
Corporate - $50 |
|
|
|
|
|
|
|
LIFE MEMBERSHIP - $500 |
|
|
|
|
|
|
|
DONATION |
|
|
|
|
|
|
|
NOTE: Donations of $2 or more are Tax Deductible |
|
|
|
|
|
|
|
|
TOTAL |
|
|
DETAILS: |
|
|
|
|
|
|
|
NAME |
|
|
|
|
|
|
|
ORGANISATION |
|
|
|
|
|
|
|
ADDRESS |
|
|
|
|
|
|
|
TELEPHONE: |
DAY |
|
|
|
EVENING |
|
|
|
MOBILE |
|
|
|
|
|
|
|
|
|
|
Do you wish to receive emails about forthcoming meetings or events. YES NO |
||
PAYMENT OPTIONS
|
|
|
Cheque |
|
|
|
Please print this form and send with your |
|
cheque to: |
|
|
|
The Treasurer |
|
Friends of Battye Library |
|
PO Box 216 |
|
NORTHBRIDGE WA 6865 |
|
|
|
Make cheques out to : |
|
“Friends of Battye Library” |
|
|
|
|
|
|
Electronic Funds Transfer (Australian Residents Only) |
|
|
|
|
|
Account Name: |
Friends of Battye Library |
|
|
|
|
Bank: |
ANZ |
|
|
|
|
BSB: |
016-185 |
|
|
|
|
Account Number: |
4220-58413 |
|
|
|
|
Please enter bank receipt number:
|
|