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Annual Membership is $30.
Concession is $10.
Please make cheques payable to CICD and post with this form to:
CICD Membership,
PO Box 50 Carlton South. 3053
Victoria. 3053
Name: ________________________________________
Profession: _____________________________________
Address: _______________________________________
_______________________________________________
State: ____________________Postcode: _____________
Email address: __________________________________
Telephone: (___) ___________________
Fax: (___) _________________
Membership: $___________
Donation: $___________
Total payment: $ ___________
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