Vegetarian
Society of the Australian Capital Territory
Membership Subscription / Renewal Form
Please print, complete and post with cheque or money order to:
| ACT Vegetarian Society Inc. |
| GPO Box 1786 |
| CANBERRA ACT 2601 |
| ph: (02) 6258 7130 |
(Sorry, we are not able to accept credit card payments)
| Name: ____________________________________________________________ | |||
| Address: __________________________________ | |||
| Suburb: _______________________ State: _______ | Post Code: __________ | ||
| Phone: ( __ ) _______________ home | ( __ ) _______________work | ||
| Email Address: _________________________________________________________ | |||
| As a member I would like to receive (please tick one magazine OR you may select both for an extra $22)... | |
| Vegan Voice |
OR
Natural Health and
Vegetarian Life |
| Signature: ___________________________________ Date: ___ / ___ / 20___ | |
Type of subscription (please tick one) |
||
* Associate $16 |
Membership fee: | $ _______ |
| Single $25 |
Donation: | $ _______ |
| **
Family or Organisation $30 |
Extra magazine ($22): | $ _______ |
| Enclosed is cheque/money order for (total): | $ _______ | |
| * Associate membership includes discounts and newsletters but does not include a magazine subscription | ||
** Family members of the Society receive two cards - one for each name listed. Please complete the following information if your subscription is for a family membership: |
|
Name for second membership card: _________________________________________________ |
January 2006
![]() Vegetarian Society of the
Australian Capital Territory Please print, complete and post to:
|
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April 2003