|
Maffra & District Historical Society Inc
R/N A1889 ABN 87 358 170 854
Application for Membership - 2008 |
| Please
enroll me as a member of the Maffra & District Historical Society Inc for
2008
|
| Name |
|
| Address (home) |
|
| Address (postal if different) |
|
| |
|
| Payment of $15 |
I enclose a cheque/postal
note
(made out to Maffra Historical Society) |
[ ] |
| |
I have made a deposit into
your account |
[ ] |
| |
BSB 633
000 126114107
(please endorse "Membership + your name) |
| Signed |
|
| Mail to
|
Maffra & District Historical Society
PO Box 321
Maffra
Vic 3860 |
| or
deliver personally to |
Maffra Municipal Library
Johnson Street
Maffra
|