Uniting Church National History Society Membership

Uniting Church National History Society Membership

Form
Annual Membership fee (normally for calendar year, 1 Jan. – 31 Dec.) : $ 25

Fees received in the last quarter of the year will be deemed
to be for that quarter and the whole of the following year.
Name

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
To become a member or renew your membership, we encourage
you to pay by Direct Deposit or by Cheque at:

By Direct Deposit

BSB: 032-828
ACCOUNT NO.: 301985
ACCOUNT NAME: Uniting Church National History Society

By Cheque

Uniting Church National History Society Treasurer Robert Renton

Send to:

ATTN: Uniting Church National History Society Treasurer
Rev. Professor Glen O’Brien,
28 Bindaree Court, Mernda Vic 3754
Should be Empty: