MOWatch Incorporated
ABN 91 404 102 575
Registered Association No. A8603A
Name
Address
Postcode
Phone: Bus.
Private
Fax
Email
I wish to (please tick)
.........
renew National Membership*
.........
take out National Membership*
I enclose (please tick)
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Full National Membership* $30.00
.........
Concession National Membership* $20.00
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Donation for MOWatch of $...........
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Donation for SydneyMOW of $............
Total
$..............
I wish to be a member of Sydney MOW*
yes/no
* Please indicate if you wish your National Membership (full and concessional) to include full financial membership of Sydney MOW.
Please print this form and send, with membership fee, to:
Kathy Toal
Treasurer and Public Officer
MOWatch
27 Springfield Street
Briar Hill Victoria 3088
