Joining

I/We agree with the Aims and Philosophy of the Atheist Foundation of Australia Inc, and hereby apply for Membership

SURNAME_______________________________ (BLOCK LETTERS PLEASE) GIVEN NAME (or initials)_____________(Ms/Mrs/Mr/Dr/Prof)______

ADDRESS_________________________________________________

Suburb/Town___________________________State______________Postcode______

Phone________________Email_________________________Occupation (optional)___________________________

FULL MEMBERSHIP (per year) includes 6 issues of “The Australian Atheist” Magazine
Single $25-00....Double $30-00....Student $15-00 see Student Membership Form .....$________

5 YEARS FULL MEMBERSHIP Single $105-00....Double $135-00 ....$_______

LAMINATED MEMBERSHIP CERTIFICATE...$5-00......$______

Would you prefer your Magazine sent by email?.... YES.....NO.......

DONATION...$__________ TOTAL ENCLOSED...$__________________________

SIGNATURE ____________________________

PAYMENT OPTIONS

Cheque/money order made payable to: Atheist Foundation of Australia Inc and forward to
Ms Lee Holmes (Treasurer)
Private Mail Bag 6
MAITLAND S.A. 5573

DIRECT DEBIT to
Commonwealth Bank
BSB Number 065503
Account Number 10120389

PAYMATE
(fill in Order/Item number on PAYMATE form as Membership) PAYMATE:

If paying via PAYMATE or a DIRECT DEBIT please complete the MEMBERSHIP FORM (Word Doc) (fill in Order/Item number on PAYMATE form as Membership) and forward to: info@atheistfoundation.org.au
The completed form should be saved into your files OR copied into the face of an email.

Home