NETHERLANDS ASSOCIATION OF QLD
ABN 17 909 018 044
Membership Application/Renewal Form Annual Membership from 1st July to 30th June
Title
Select one:
Mr
Mrs
Ms
Dr
Renewal/New
Choose one:
Membership Renewal
New Membership
First Name
Last Name
Address
City
Date of Birth
Post Code
Phone
Mobile
Email
Please Note:
5 YEAR Membership*: Multiply your membership fees and take 20% off - (*Only Available for 2023-24)
Magazine subscription is only for the magazine and does not give you voting rights.
Please consider paying a little more which will enable you to have your say at General Meetings.
Membership Type:
Choose your Membership:
Family - incl. children to 18 years - $50
Single - $35
Pensioner Couple - $35
Pensioner Single - $30
Magazine Only - $25
By Cheque or Money Order payable to:
Netherlands Association of Queensland
PO Box 228
Civic Centre Inala QLD 4077
or: Payments can be handed to the Treasurer or at the shop in the club. (this is applicable for cash payments)
Payment can also be made by Electronic Funds Transfer (Bank Details will be sent to you by email)
Standard Or 5 Year:
One Year Membership (No Discount)
Five Year Membership (20% Discount)
Choose your Payment Method
Choose a Payment Type:
Payment by Cash
Payment by EFT
Payment by Cheque
Payment by Money Order
Select Payment Date
By Checking the below you are electronically agreeing to the terms of membership with the Netherlands Association of Queensland. In this case you do not need to physically sign the form. However, if you print the form and fill it in you will need to sign the form when sending it in with your payment.
Yes, I am interested in Volunteering
Signature
I Accept the Terms and Conditions of Membership
Use the Reset Button to clear the form
Use the Submit Button to send the form
Please remember to make your payment after submitting the form.
You will receive an email to confirm the your submission.
New memberships are not automatic and subject to approval of the committee. Once approved you will be notified of your membership.
By signing the membership form you give permission to have a member of the Committee contact you.
The Club survives because of our tireless Volunteers: We have a pool of volunteers that help when they can, if this interests you please say YES on your membership form and a member of the committee will contact you to discuss.
Please enter the code above in the box below.
Can't read the image? Please click
here
to refresh