Membership Application

Please download the page and send Application with payment to: Send Applications to: PO Box 1142 canning Bridge WA 6153 Email: hugh@clubshare.com.au Fax: +61(08) 9313 1206- Phone: +61(08) 9313 1951 MEMBERSHIP APPLICATION $AU22.00 pa(inc GST)
TITLE
FAMILY NAME
GIVEN NAME
ADDRESS
POST OR ZIP CODE
PHONE
FAX
EMAIL
CREDIT CARD
NAME ON CARD
CREDIT CARD No
EXPIRY DATE
Copy & Paste this Application on EMAIL TO SEND EMAIL CLICK HERE OR Credit Card details can be phoned through If you are on SKYPE it is a FREE CALL email your SKYPE address SKYPE On receipt of Application you will be sent a receipt with membership details by email