COG Membership Application Form

Canberra Birds Membership Application / Renewal
This form is for all NEW and RENEWING members. Please provide all requested information (marked with an asterisk) to ensure our records are accurate.

Payment. At this time payment can only be made by Bank Transfer (EFT) to Canberra Birds' bank account.
1. Your details
Name*

PrefixFirst NameLast Name
Contact name*

First NameLast Name
Name of Institution (Organisation Members only)
Address*
Street Address
Street Address 2
Town/Suburb
State
Postcode
Country
Email*
example@example.com
Phone*
2. Membership and payment
Membership Type*

Individual - $50Institution - $50Family - $55Student - $20
Joining or renewing?*

New memberRenewal
Names of partner/ children covered by this Family Membership*
Donation
Donation to Canberra Birds Conservation Fund
Total to pay .... $
Don't forget to pay!

Bank Transfer (EFT) - Transfer funds to:

Canberra Ornithologists Group Inc.
St George Bank
Acc number 050111462
BSB 112-908

IMPORTANT! Please include your name and the word 'Sub' as the 'Description' when you make your EFT transaction. For example: Sub Mary Smith
3. Volunteering
Do you have any skills that you would be willing to use to assist COG eg database management, general volunteering, leading field trips, hosting a book stall?
4. Canberra Bird Notes
Canberra Bird Notes is published two or three times a year. Most people read it electronically, on the website. If you prefer to have a hard copy mailed out to you, please select below.
Please send a printed copy of Canberra Bird Notes by post
Should be Empty:

Canberra Birds Membership Application / Renewal

1. Your details

2. Membership and payment

3. Volunteering

4. Canberra Bird Notes