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PS Superannuants New Member Application
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Title *
Required
If you ticked Other (above) please specify
Surname *
First name *
Address Line 1 *
Address Line 2  Suburb/Location, State/Territory and Postcode *
Year of Birth *
E-mail  provision will not prevent postal delivery of the Superannuant *
Telephone *
 Department from which you  are currently working with (If retired answer N/A)
 *
 Department from which you  retired from (if still working answer N/A)
 *
Jurisdiction of your employment *
Paid up Partner Member's name (if any)
Membership Type *
Required
Voluntary Levy (to bolster dwindling reserves): $15
 *
How do you want to receive your copy of The Superannuant *
Payment Method (Payment should be made at the time of application, no invoice will be sent) Please ensure that your surname is entered first if you are paying by bank transfer. *
Required
1 Name on Credit Card
2. Credit Card Number
3. Card Expiry Date
MM
/
DD
/
YYYY
4.CVC or CVV
Total payment by card or EFT including credit card fees *
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