Balwyn Historical Society

Membership Application
     

Name(s)    

Address    

Suburb             Postcode    3nnn

Phone                  Mobile 

Email      

Type of membership      Single   Joint -- 2 adults at same address

  Membership fees for 2013/14     $25 single   $35 joint
           

                   To apply for membership, please fill in this form (you may do this on your computer). Then you may print t5he form and either :

                  ●       Bring it with your payment (cash or cheque)
                                to a BHS meeting

                  ●       Mail the form with a cheque payable to the
                                Balwyn Historical Society, at 
          
                     45 Talbot Ave, Balwyn 3103.

 

 

 

                                          

               
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