Clarence Landcare Individual Membership Form

Individual Member Application Form

Application forms are approved at monthly management committee meetings. Your email address will then be added to the Newsletter List. If you do not receive a Newsletter toward the end of the month, check your SPAM inbox to make sure you accept Clarence Landcare emails.
Name

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Address (If Different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone

Area CodePhone Number
Mobile

+61Phone Number
YesNo
NoYes
If yes, name of group
YesNo
NoYes - Please 'like' & 'follow' Clarence Landcare at the link below
Clarence Landcare Facebook
Yes
Certificates/Qualifications
First AidChemcertWhite CardChainsaw OperationsOther
Areas of Interest
Native plants and animalsThreatened speciesStingless native beesCreek and river bank managementWetland managementFish and their habitatSustainable agricultureCertified organic food productionPasture and soilSoil erosionDung beetlesCane toadsDisaster resilience, recovery and preparedness.Indian Myna Bird ControlOther
Code of Conduct for Members, Groups and Volunteers

(if link does not work the one page document can be found on www.clarencelandcare.com.au/about/governance )
Yes, I understand that as a member of Clarence Landcare I accept the Code of Conduct.No, I do not accept the Code of Conduct.
Date

DayMonthYear
Thank you for taking the time to complete the above information.

Clarence Landcare Inc

Street Address: Suite 1, 48 Prince Street, Grafton. NSW. (Upstairs)

Postal Address: PO Box 594, Grafton. NSW. 2460

Ph: (02) 66435009

Email: landcare@clarencelandcare.com.au

Landcare membership is currently free. This may change in the future. Your membership application form will be presented for approval at the next monthly Clarence Landcare management committee meeting.
Should be Empty:

Individual Member Application Form

Certificates/Qualifications

Areas of Interest