Membership Form

GMLL Membership

Group Membership
Details of group
Group name
Group Contact Person

First NameLast Name
Email - Applicant
example@example.com.au
Mobile Phone

Area CodePhone Number
Mailing Address

Address Line 1

Address Line 2

Town/SuburbState

Postcode
Property Address (if different)

Street Address Line 1

Street Address Line 2

Town/SuburbState

Postcode
OR

Individual/Family Membership
Details of Individual applicant
Name - Applicant 1

First NameLast Name
Email
example@example.com.au
Mobile

Area CodePhone Number
Details of family members (if applicable)
Name - Applicant 2

First NameLast Name
Email
example@example.com.au
Mobile Phone

Area CodePhone Number
Name - Applicant 3

First NameLast Name
Name - Applicant 4

First NameLast Name
Name - Applicant 5

First NameLast Name
Address details
Mailing Address

Address Line 1

Address Line 2

Town/SuburbState

Postcode
Property Address (if different)

Street Address Line 1

Street Address Line 2

Town/SuburbState

Postcode
About you and your interests
Age Group

Under 3030-60Over 60
Property size (ha):
Years on property:
Land use - % Commercial Agriculture:
Land use - % Conservation:
Land use - % Lifestyle:
Interests:

Bushfire Risk ManagementBiodiversityCattle and Sheep FarmingPest AnimalsEnvironmental EducationErosion ControlHabitat RestorationHorticultureIndigenous Land ManagementLocal Food productionWeedsNative VegetationRevegetationRivercare and WetlandsSoil ManagementSalinity and AcidityThreatened SpeciesTraining CoursesTree DiebackTree and shrub plantingWater ManagementWool ProductionOther
Membership type and payment

(Membership follows the financial year and is per individual)
TERMS AND CONDITIONS OF MEMBERSHIP
All new members of Goulburn Mulwaree Landcare Landscapes (GMLL) will be subject to approval by the GMLL committee and any new application will be presented to the committee at the next quarterly meeting. All new members will be required to adhere to GMLL Constitution, namely, to abide by the Constitution and work in the best interests of the association. New members are also requested to adhere to the code of conduct principles as set out by Landcare NSW.

My Products

Group 12 months membership

$50.00AUD Quantity

Individual 12 months GMLL membership

$20.00AUD Quantity

Product NameFamily 12 months GMLL Membership

$30.00AUD Quantity

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

GMLL Membership

Details of group

OR

Details of Individual applicant

Details of family members (if applicable)

Address details

About you and your interests

Membership type and payment