|
Membership & Renewal
Application Form For Victoria
Our membership period is from 1st January to 31st December
each year
|
To join Speak Easy
please complete the form and press submit and
post your cheque to
'Victoria Speak Easy Association'
Treasurer
35 Ryans Rd,
Eltham, VIC, 3095.
If you prefer you can print
the form and post it to us.
You will need Acrobat
Reader 3.0 or higher to view this
To make a donation to our Association go to our
donation
form
Required
fields *
|
|
|
Please accept my application for membership to Australian
Speak Easy Association
|
 |
*Type
of membership
(Tick one box)
|
|
|
|
*Joining
Month
|
January, February or March
|
$35.00
|
* $20.00
|
|
Tick one box
|
April, May or June
|
$27.00
|
* $15.00
|
|
|
July, August or September
|
$18.00
|
* $10.00
|
|
|
October, November or December
|
$9.00
|
* $5.00
|
|
(* concession card
holder/full time student or junior under 17 years)
|
| Personal details |
my details are available for the use of ASEA only; or |
|
my details are also available to related speech & research
organisations |
|
|
*Age
group
(Tick one box) |
|
|
|
|
| I
have posted a cheque for
including/or a donation of
* on (Date)
|
| |
|
("The ASEA is a
registered Public Benevolant Institution (DGR 486 946)")
("Donations over $2 are tax deductible")
|
|
|
Would you like
a receipt
Yes
No
|
|
Cheques
should be made payable to
'Victoria Speak Easy Association'
and posted to
Treasurer
35 Ryans Rd,
Eltham, VIC, 3095. |
|
Membership
