MEMBERSHIP APPLICATION/RENEWAL FORM

C.G. JUNG SOCIETY OF MELBOURNE Inc.

A0009381F

I wish to:             □  BECOME A MEMBER             □ RENEW

(Membership runs from July 2006-June 2007 or the 2007 calendar year)

FULL NAME:                                                                                                        
(Block Letters) 

ADDRESS:                                                                                                             

                                                                        POST CODE:                               

TEL: Home:                                                   Work:                                             

EMAIL:                                                                                                                   

CURRENT MEMBERSHIP NO:                                                                         

DATE OF BIRTH:                    _  _ OCCUPATION:                                 _       

In the event of my admission as a member to the C.G. Jung Society of Melbourne Inc., I agree to be bound by the rules of the Society. A copy of the Constitution is available at the entrance desk at the monthly meetings. 

SIGNED:                    _                                               _ DATE:                                 _

 Joining Fees:

New Members (joining fee payable once)                        $15

Single Membership                                                         $95

Family Membership (partner/children)                            $165

Concession (Please supply some verification)                   $50                   

AMOUNT ENCLOSED:                                    $               ____

Please send this application with cheque/money order to: The Membership Secretary, C.G. Jung Society of Melbourne Inc., P.O.Box 517, Heathmont, 3135
 

To avoid long queues at the lectures, please mail your application. We will send your membership and library card by return mail.