Member Application Form
The membership fee is $50 per couple which can be paid by cheque or direct banking payment, details can be found at the end of the form.

To Join SeniorNet Mac Inc. please fill in the details and complete this online form.

Your Surname
Your answer
Your First or Given Names
Your answer
Partners Surname
Your answer
Partners First or Given Names
Your answer
Actual Address
Your answer
City or Province
Your answer
Post Code
Your answer
Postal Address (if different from above)
Your answer
Phone Number
Your answer
Mobile Number
Your answer
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