MEMBERSHIP APPLICATION FORM

Please print and send the following form and mail to the the Hon. Treasurer at "endersby" at "mira" dot "net". Assistance with Proposer and Seconder's signatures can be provided by the Society.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 
MEMBERSHIP APPLICATION

APPLICANT
            Full Name ................................................

            Address   ................................................

                      .................................Postcode ......

            Phone (  )..............................

            Interests ................................................

            .................................................................


I hereby apply for ordinary/country/student/associate/life membership of the
Society and, if elected, agree to be bound by the provisions of the Constitution.


            Signature ............................ Date ..............

PROPOSER:
            Full Name .............................................

            Address   ..............................................

            Signature ........................... Date ..............
 

SECONDER:
            Full Name .............................................

            Address   ..............................................

            Signature ........................... Date ..............
 
Memebership Categories:

1. ORDINARY Members are persons over the age of 18 years paying an annual
   subscription to the Society.
2. COUNTRY Members are ordinary members who reside more than 100 kilometres from
   the Melbourne GPO.
3. STUDENT Members are persons under the age of 18 years or who are bona fide
   full-time students of a school, college or university, paying an annual subscription
   to the Society.
4. ASSOCIATE Membership is restricted to the immediate family of any person annually
   paying an Ordinary Membership subscription to the Society, and who are resident at
   the same address.  Such Associate Members are not entitled to receive the Society's
   publications, but in all other respects they rank equally with Ordinary Members.
5. LIFE members are ordinary Members who have paid a single lump sum to cover all
   future membership subscriptions dring their lives.

PLEASE RETURN TO THE HON. TREASURER: Mr. Ian Endersby

56 Looker Road, MONTMORENCY   VIC.   3094

SUBSCRIPTIONS, 2008: Ordinary $30; Country $26; Student $18.  Overseas members (Including overseas Student). $32
Associate $7 (no news bulletin); Electronic (news bulletin emailed) $20
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

APPLICATION FORM

Subscriptions are due at the beginning of each calendar year.

Applications should be forwarded to:
Mr Ian Endersby, Honorary Treasurer,
Entomological Society of Victoria,
56 Looker Road,
MONTMORENCY VIC., 3094 AUSTRALIA

Go back to home page or Go To Top of Document