BMQ Membership Application Form 2024-25

Membership Application Form

Blue Mountains Quilters Inc: For the period to 1 July 2025 to 30 June 2026
New Members: $60 Optional Name Badge $15

Payment may be made by direct deposit only to:

Blue Mountains Quilters Inc BSB: 633000 Account 161734967

Make your payment. Include your name as a reference.

Then complete the online form below.
Name*

First NameLast Name
Badge Name Preference
Address*

Street Address

Street Address Line 2

Suburb/TownState / Province

Post Code
Preferred phone number*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact
Name & telephone number
Fees:
prevnext( X )
Membership to 30 June 2026
$60.00AUD

Name Badge (optional)
$15.00AUD

Total

$0.00AUD
Date and time of deposit:*
Comment:
When you submit your form, you will receive a confirmation e-mail for your records. Check your junk mail folder!
Tick the box if you DO NOT consent to your image being used by Blue Mountains Quilters for promotion in print and online platforms.

I DO NOT want my image used by BMQ
Should be Empty: