Friends of the Koalas - Membership Subscription Form

Friends of the Koalas Inc. Annual Membership Form

Surname:

First name/s:

Address:

Cheque/money order to the value of $................. enclosed. (Please make cheques and money orders payable to Friends of the Koalas Inc. Please use Australian dollars.)

Type of membership required (circle one):

Family - A$25
Single adult - A$15
Corporate - over A$50

Concession - A$10
Student - A$10
Supporting - over A$25

For office use only
Receipt issued Date	Membership no. Date

Mail this form to:

Membership Secretary
Friends of the Koalas Inc.
PO Box 231
Cowes V 3922