Application form to join Greenlink, Box Hill

Print this form out, complete the questions below and send, with your cheque or money order to:

I wish to join Greenlink Box Hill Inc.

Annual subscription enclosed....................................$_______
(Household $20, Individual $15, Concession $7, Junior $7)
If "Household", how many members are covered by this membership? ___
(we need this information for insurance purposes only)
Total payment enclosed..........................................$________

Name: _________________________________________________________

Address: ______________________________________________________

_______________________________________________________________

Phone: ________________________________________________________

E-mail address: ___________________________________________________
(Only if you would prefer to receive your newsletter via e-mail)

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