The Fern Society of Victoria Inc.

ABN 85 086 216 704

Membership Application

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Title (Mr, Mrs etc)...................Surname .............................................

Given name(s).................................................................................

(Given names of other interested family members........................................................................)

Address.......................................................................................

..............................................................................................

..............................................................................................

Postcode.........................

Phone .........................................

E-mail ......................................................... Fax..................................................................

Membership Category ............................

Date ............................................

Signature........................................................

Post to
Membership Secretary
The Fern Society of Victoria Inc.
34 Noble Way
Sunbury
Vic   3429

Membership Categories ---Annual Subscription Fees
Single      $17
Family      $19
Student/Pensioner   $14
Pensioner Family   $16
Organisations   $20
Overseas (Air Mail)   A$25 (Payment by international Bank Cheque in $A please)

Subscriptions fall due on 1st of July each year.
New subscriptions received in January to June carry through to June of the following year.