Victorian Bicycle Coalition Inc.

Membership form

NAME OF GROUP

CONTACT PERSON

ADDRESS

PHONE (home) (business)

FAX:

E-MAIL

PAID-UP MEMBERSHIP OF GROUP

Membership costs $1 per paid-up member of your group up to 50 members and is negotiable for larger groups.
Please send completed form to:
The acting Secretary, John Harland
Victorian Bicycle Coalition
16 Jervis St
Burwood, Vic 3125
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