North East & Surrounds Equine Landcare Inc. Membership form


Membership from 1st July to 30th June annually

Annual membership - $25 per household

Direct Deposit to: North East & Surrounds Equine Landcare Inc.
BSB: 633 000 Acc No: 161 110 234 (use your SURNAME name as reference)
Cheque made out to: North East & Surrounds Equine Landcare Inc.

North East & Surrounds Equine Landcare
541 Greta Road, Glenrowan West, Victoria, 3675
E: nesel.group@gmail.com
First Name *
Last Name *
Other family members
Number and Street *
TOWN *
Postcode *
Your email address *
Home phone
Mobile number *
Do you have any skills or ideas that can support our committee? (monthly meetings 2nd Monday month) *
Property size *
Number of horses *
Are you a member of any local riding clubs *
If YES please specify
Are you a member of a Landcare group *
If YES please specify
Interests *
Required
Payment method *
Signature *
Required
Submit
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