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.) Subscriptions are due as from the 1^st of January each year.

Type of membership required (circle one):

Family - A$25 (Up to 2 adults & 2 children 15 yrs and under)

Single person - A$15
Corporate - over A$50

Concession - A$10 (Australian Pension Card holders)
Supporting - over A$25

For office use only
Receipt issued Date	Membership no. Date

Donations to Friends of the Koalas enables us to continue our vital work. Payments of $2.00 & over are tax deductable.

Mail this form to:

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