Membership Form

PHILLIP ISLAND CONSERVATION SOCIETY INC

I/We want to support the work of Phillip Island Conservation Society by becoming a member.

Name_______________________________________________________

Address______________________________________________________

Telephone_________________________Fax_________________________

Email_________________________________________________________

Subscription rates:

Single $15____ Family $25____ Concession $10____Supporting $30+____

Donation_____

Send to: PICS Treasurer, PO Box 548, Cowes, VIC 3922

If you are a new member, please let us know how you would like to assist with the work of PICS:

Word processing/computer Minutes Secretary Committee member

Treasurer/bookkeeping Artwork Filing Red Rocks Coast Action Coordinator

Children's Environmental Mornings Assistant Publicity

Writing letters Preparing submissions Photocopying

Fundraising History research Newsletter team Nature watch

Attending Shire Council meetings Other

What are your special areas of concern or interest?