Membership Application Form

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Membership Application Form

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* Indicates required question

Salutation *

Choose

Mr

Miss

Mrs

Ms

Dr

Last Name *

Your answer

First Name *

Your answer

Membership Type *

Adult Member (Annual Fee $45)

Family Member (Annual Fee $55)

Birthday *

MM

/

DD

/

YYYY

Street Address *

Your answer

Suburb *

Your answer

Postcode *

Your answer

Contact Number *

Your answer

Your Email *

Your answer

Emergency Contact (Name and Contact Number) *

Your answer

Occupation *

Your answer

Interests *

Your answer

Astronomy Equipment, if any *

Your answer

What inspired you to join our society? *

Your answer

How did you hear about us? *

Your answer

Submit

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