Membership Application / Renewal
Now - 30 June 2009		 BPG logo
In accordance with the
Rules of the Association,
Membership Renewal Subscriptions
are payable on or before July 1  2008.

Please fill in and return
with your payment and/or donation.                            Your MEMBERSHIP is WELCOMED!
 
Given Name
 
Family Name
 
Address
 
   
Postcode
 
Phone
         
Email
         
 
Please make corrections and additions (like your email address) so we can keep you informed.
Unwaged membership  
$  5
    Please tick appropriate boxes below
Waged membership   
$15
     
Family (all 16 and over)   
$25
     
Donation       
$    
     
Bequest from my will
        Please send an info kit or CLICK here
 
Please find enclosed my payment
  $      

Return this page with your payment to:

The Treasurer
Bassendean Preservation Group Inc
PO Box 75
Bassendean  WA  6934                                                                               BACK