NOTE: To order print the completed
form then mail or fax it with your payment to the address
below. This form can not be submitted online.
Send the completed form below with cheque or money order to:
Friends of STARTTS PO Box 203
Fairfield NSW 2165
Or Fax printed form with payment details to: +61 (2) 9794 1910
____________________________________________________
Contact Details
Payment Details
Title
Cheque to: Friends of STARTTS
Name
Money Order to: Friends of STARTTS
Surname
Credit Card (Bankcard/Master Card/Visa)
Organisation
Card Holder's Name
Address
Card Number
Town
Expiry Date
State
Signature
________________
Post Code
Date
Country
Telephone (H)
Telephone (W)
E-mail
Total Cost
(see below)
Membership type
Single $60
Concession (Refugee, Unemployed, Pensioner, Student, Struggling, Active
volunteer) $10
Donation
I do not want to be a member
I Would like to make a donation instead?
Enter Amount
Note: Include an additional A$10 for postage and handling
services if you are outside Australia. Membership includes subscription
to Transitions Magazine.
Friends of STARTTS - Membership Form and Subscription
to Transitions Magazine