Membership Application

APPENDIX 1
Membership Application/Renewal for Ratepayers Victoria, Inc. (A0040924M)
1/7/2019 to 30/6/2020

Name:______________________________________________________________________

Organization:______________________________________________________________

Shire/Council:_____________________________________________________________

Address:___________________________________________________________________

Post Code: ____________________

Phone: ______________________________ Mobile:___________________________

E-Mail: _______________________________________________

In the event of my admission to membership, I agree to be bound by the rules of the Association for the time being in force, to pay annual membership dues as determined by the association, and to work cooperatively with the other members.

Signature __________________________________ Date ________________

APPENDIX 3
Membership Fees for Ratepayers Victoria Inc. (A0040924M)

Membership Fees: $10 Pensioners $20 Individuals $40 Organization
Enclosed: $
Additional donation optional $____________________
Cheque/Money Order /Cash or
Bank deposit to: Ratepayers Victoria Inc.
Whittlesea branch: BSB No: 063 855 Account No: 10127765 ____________________________________________________
Mail To: The Secretary 8/1248 North Road, Oakleigh South.Vic.3167 or Email: ratepayersvic@outlook.com

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