Research BVHS

MUSEUM

BRUNSWICK VALLEY HISTORICAL SOCIETY INC.
Cnr Stuart & Myokum Sts, Mullumbimby.
PO Box 378, Mullumbimby, NSW, 2482.

Phone: 02 6684 4367

Email: admin@mullumbimbymuseum.org.au

Website: www.mullumbimbymuseum.org.au
REQUEST FOR RESEARCH
FEES: Our research fee is $20 for the first hour and $15 per hour thereafter. Please be aware that even though we conduct a thorough research we may not find anything.

Please pay via PayPal here or make your cheque/money order payable to: Brunswick Valley Historical Society Inc and mail it to PO Box 378, Mullumbimby, NSW, 2482.

Ours is a volunteer organisation and your contribution will go towards making sure we are able to store and preserve information for you and others who might seek it in the future.

When we receive your payment and this request form we will proceed to make searches on your behalf. We will be in touch as soon as we have completed our research.

Many thanks.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Please enter a valid phone number.
Your Email Address *
example@example.com
Question to research: *
What else do you know that could help us? *
Today's Date *

Month Day Year
Date
Signature *

Please use your mouse on a desktop or finger on a mobile device to write a facsimile of your signature. Clear
Please check this box to verify that you are human *
My Products *

prev next ( X )
AUD $20 for the first hour. As it is impossible to know how long the research will take we will accept payment for first hour and then we will contact you if we require more time.
Note: Because this form was made on a free public platform called Jotform - when you receive your email copy of your completed Request - it will have a small ad at the bottom with a button encouraging you to sign up and create your own forms - which you can just ignore - unless you have a need for online forms.

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

MUSEUM

REQUEST FOR RESEARCH