Maffra & District Historical Society Inc
R/N A1889   ABN 87 358 170 854

Application for Membership - 2013

 

Please enroll me as a member of the Maffra & District Historical Society Inc for 2012 ($20)

or

Sign me up for an Annual Bulletin Subscription ($15)

 

Name  
Address (home)  
Address (postal if different)  
   
Payment 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/Bulletin + your name")
 

Signed

 
 

Mail to

 

 

Maffra & District Historical Society
PO Box 321
Maffra
Vic  3860