Membership Application


Queensland Begonia Society Cheque Payment

Queensland Begonia Society Inc.
Membership Form

Name – Member 1 Preferred Name
Name – Member 2 Preferred Name
Address
Postcode
Phone Home Mobile
Email
Social Media Alias
(if used)
Emergency Contact Name Phone
Do you wish to withhold your details from publication? Yes/No
Signature
(typed name acceptable)
Date
QBS carries Public and Product Liability Insurance to the value of $20,000,000
Annual Membership Fees
Single with receipt of newsletter by Email
Single with receipt of newsletter by mail
Family with receipt of newsletter by Email
Family with receipt of newsletter by mail
Fee
$25
$35
$30
$40
Membership due by 31st December each year
Payment Details
Direct Deposit to Bendigo Bank. BSB 633-000 Account Number 172664849
To allow tracking of payment please add surname as reference when making Direct Deposit.
Email completed form to – membership@queenslandbegoniasociety.com
Cash/EFTPOS at Monthly Meetings.
Please print and hand this form to the Treasurer when making cash/EFTPOS payment.
Other Methods of Payment. Please contact the QBS Secretary –
secretary@queenslandbegoniasociety.com
Amount Paid: $
Method of Payment
(insert date)
Cash/EFTPOS Direct Deposit

 

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3 thoughts on “Membership Application

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