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Membership Application Form
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THE MID GIPPSLAND

FAMILY HISTORY SOCIETY Inc

Association number A0023846S.  ABN 88 735 748 406

44 Albert Street, Moe Vic, 3825

mgfhs.inc@gmail.com

Application for Membership

To the Committee

I, ....................................................................................................................... , (print name)

of .........................................................................................................................., (address)
wish
 to become a member of The Mid Gippsland Family History Society Incorporated.

I agree to support the Purposes of the Society and to comply with the Society’s Rules (available at http://home.vicnet.net.au/~mgfhs/admin.htm or on application)

Signature of Applicant..........................................................................Date...................................

Send the completed form to the Secretary at the address above or arrange delivery by hand.

Fees to accompany application as shown below.  Membership renews next August

▢  Single Subscription: 12 months        $25                ▢  Family Subscription: 12 months        $30

▢  Single Subscription: After Janry        $12.50                ▢  Family Subscription: After Janry        $15

Additional Contact Details

Postal Address

if different to above*

Phone

  Landline:                                           Mobile:

Email address

By default, the MGFHS will send all official communication to your email address, if valid.  

* Tick here: ▢ and we will only use your postal address.

Member’s Interests  (Please show Surnames with the appropriate Periods, Regions or Countries).

Free listing of Family Research for financial members on mgfhs.org

Membership         ▢ Accepted by the committee.                Date........................................................

▢ Applicant notified

▢ Membership Register updated                Date.........................................................

Receipt No:_______         New member kit supplied: _____