Individual Membership Renewal

Do you wish to renew your membership?

Yes

No

I wish to be contacted about individual membership renewal

Please select the membership option that applies to you:

Waged 1 year membership $33.00

Unwaged 1 year membership $22.00

I wish to seek a fee waiver for next year's membership

Please provide your contact details below

First name

Last name

Organisation (if any)

Email

Phone

Address

State/Territory

Postcode

I certify that the above contact information is correct:

Your name

Signature

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Date