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Membership Application
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If you live in Australia and would like to become a member of the Ballarat Rail Promotion Group (Inc) simply complete the following form or download the membership form.

Your application will be processed and you will receive confirmation of your application.  You will also receive an invoice for the subscription fee.  Upon paying the invoice, your membership will become active.

The membership subscription is currently $15.00 per annum.  This will be applied on a proportional basis for memberships received between 31/12/99 and 30/06/00.

NAME

Title
Given Names
Surname

ADDRESS

Additional Info
Street
Town
State
Postcode

CONTACT

Telephone (AH)
Telephone (BH)
E-Mail
OTHER
Occupation
Age (If Under 18 Years)

COMMENTS

 

By clicking on <Submit> you apply for membership and if your membership is accepted you will agree to abide by the rules of the association.

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Monday, 08 May 2000 08:00:59 -0400