Music Broadcasting Society of NSW Membership Form
Please indicate whether you are a new member or an existing member.
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New member
Existing member
Are you a volunteer?
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Name
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Title
First name
Middle name
Last name
Post nominals
Mobile number
Home phone number
Email address
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Address
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Street
Street Address Line 2
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Comments
Submission Date
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Month
Year
Date
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Payment details
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Society Membership fee
Annual fee
$50.00 AUD
$
50.00
AUD
Society Membership fee (for members in arrears only)
Annual fee
$100.00 AUD
$
100.00
AUD
Debit or Credit Card
First name
Last name
Credit card number
Security Code
Expiration Month
January
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March
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May
June
July
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September
October
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Expiration Month
Expiration Year
2026
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2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
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2045
Expiration Year
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