148 Camden Head Road CAMDEN HEAD NSW 2443
http://forestsandclimate.org.au
2019-20 APPLICATION FOR MEMBERSHIP / MEMBERSHIP RENEWAL Date:…………
I would like to join AFCA as a member group I am renewing my AFCA group membership I would like to become an individual AFCA supporter Name of Organisation Name of Contact /Supporter Position of Contact Address Postcode Phone (work) Phone (mobile) Email Address Web address
Annual membership fee (if less than 15 members) Annual membership fee (if less than 50 members) Annual membership fee (more than 50 members) Additional donation group members (optional - please specify) Supporters donation (optional - please specify)
$20.00 $50.00 $100.00
Total amount I am paying by cheque/ funds transfer For direct funds transfer please deposit into our Bank Australia account for Australian Forests and Climate Alliance Inc BSB: 313-140 Account Number: 12167081 ---------------------------------------------------------------------------------------------------------------------I would like to make a regular monthly donation to assist the work of AFCA
$10
$20
$50
Or other, please specify ………….
---------------------------------------------------------------------------------------------------------------------I would like to volunteer to help AFCA Name …………………………………..Phone number……………………………………….. Skills or resources to share ………………………………..…………………………………..
Contact afca.forests@gmail.com or call 0448899684