Online Application for Membership of Birding NSW

Use this form to apply for a new membership

Application for membership in Birding NSW

Name:*

Title

Preferred given name

Family name

Second family member's name (if applying for family/couple membership)

Title

Preferred given name

Family name

Additional family member's name (for family/couple)

Title

Preferred given name

Family name

Address:*

Street Address City/Suburb State Postcode Country

An automatic email acknowledgement will be sent to the applicant’s email address if this application is SUBMITTED online.

E-mail: *

E-mail confirmation:*

Phone:

Area Code

Phone Number

Mobile number

Type of Membership. Please tick your category*

Adult with downloaded newsletter ($40)

Adult with posted newsletter ($45)

Family with downloaded newsletter ($45)

Family with posted newsletter ($50)

Junior (under 18 years) $15

Optional extras (price includes postage)

Name tag ($12.20)

Badge ($6.00)

Extra Name tag ($11.20)

Donation:

Total:

Payment may be made online by EFT with your own banking institution.

Account Name: Birding NSW
BSB: 062169
Account No: 10193174
Reference: your family name

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