Clan MacNicol AUSTRALIA Membership Form

Membership Application

To renew or apply for membership please complete all relevant questions.
Qualification for Membership

Any person bearing the name MacNicol in any of its various forms and spellings or any sept name of Clan MacNicol including the spouse or descendant of such person.
Any person wishing, for loyal reasons, to become a member of the Clan or renew membership.

Objects

1) To recognise and support the Chief of Clan MacNicol of the Highland Clan MacNeacail.
2) To establish, maintain and foster contact with other Clan MacNicol organisations throughout the world.
3) To inform members of Clan MacNicol about Scottish history and heritage.
4) To foster good works and charitable activities related to our Scottish ancestry.
5) To encourage participation of Scottish activities.
6) To manage funds and improve assets for the benefit of Clan MacNicol Australia.
Full Name*

First NameLast Name
Relationship to Clan if not known by Surname
Year of Birth
Postal Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
E-mail*
This will be used for sending the membership invoice and Clan Newsletter
Phone Number*

Area CodePhone Number
Family Members (for Family Memberships)
Full Name of Spouse / Partner
Please provide name and year of birth
Full Name of Children under 18 years (if any)
Please provide each name and year of birth
Membership includes a digital edition of the thrice yearly Clan newsletter "The Southern Cross". Please select this button if you'd like to receive a printed copy.

Post me a copy of The Southern Cross
Membership Fees - you will receive an email with the payment details after you submit this form.*
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Individual - NewIncludes $5 joining fee
$25.00AUD



Individual - Renewal
$20.00AUD



Family - NewIncludes $5 joining fee
$30.00AUD



Family - Renewal
$25.00AUD



Total

$0.00AUD
Voluntary donations are welcomed, please add your donation to the above sum when you pay the final amount.
Billing Address

Use the address above.I want to specify a different billing address.
Paid?
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date*

DayMonthYear
Date
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Membership Application