NPA Membership Application Form

I/We would like to join the National Parks Association of NSW Inc
and agree to be bound by the rules of the Association.

SURNAME (block letters) ........................................................

OTHER NAMES ......................................................................

ADDRESS ................................................................................

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

POSTCODE ...............................

PHONE (H) ................................. (W) ........................................

Annual Membership Fee (please tick appropriate box/es)

ADULT $43 HOUSEHOLD $48

CONCESSION $23 (circle appropriate category)
              Full-time student/Unwaged/Pension

SCHOOL/LIBRARY $50 CORPORATE $200

DONATION $
               (donations of $2 or more are tax deductible)

OPTIONAL INSURANCE CONTRIBUTION
                
$3 per person to Confederation of Bushwalkers Insurance Scheme

I can help NPA with ..........................................................................................

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

 

Payment Options I/We enclose cheque/money order for

$ ........................................................................................

being subscription for .......................................... year(s).

OR please charge my Mastercard/Bankcard/Visa
                                     (circle appropriate category)

No ...........................................................................

Expiry Date ..............................................................

Please accept your first copy of the National Parks Journal as receipt of membership.
A separate receipt will be issued for donations.

Signature ......................................................................

Date .............................................................................

Please print out and post this form, with payment, to: 
National Parks Association of NSW Inc.,
PO Box A96, Sydney South NSW 1235.
OR for credit card payments ring the NPA Office on 02 9299 0000.