Become A Member For
$10 Per Person
$30 Per Family
$5 Per Student
Allows Free Entry to Museum & Your Own Research.
$30 Per Family
$5 Per Student
Allows Free Entry to Museum & Your Own Research.
A Membership Form can be obtained by writing to the Society or by collecting a Form from the Museum.
Completed Application Forms can be mailed to the Society or left in our locked letterbox at the Old School Museum.
Completed Application Forms can be mailed to the Society or left in our locked letterbox at the Old School Museum.
| application_for_membership.doc |
MYRTLEFORD & DISTRICT HISTORICAL SOCIETY INC.
29 Elgin Street,
MYRTLEFORD VIC 3737
APPLICATION FOR or RENEWAL OF MEMBERSHIP
Annual Membership Fees are payable in October each year.
New Member .….. Renewal …… (Please tick )
Membership Fees are:
Single $20
Family $30
Student/Concession $10
TOTAL MEMBERSHIP FEE PAID: $.............
NAME(S): ……………………………………………………..
ADDRESS: …………………………………………………….
……………….. ………………………………P/CODE: ………
TELEPHONE: ………………………..
EMAIL: ………………………………………………………..
SIGNATURE(S): ………………………………………………
DATE: …../…../…..
29 Elgin Street,
MYRTLEFORD VIC 3737
APPLICATION FOR or RENEWAL OF MEMBERSHIP
Annual Membership Fees are payable in October each year.
New Member .….. Renewal …… (Please tick )
Membership Fees are:
Single $20
Family $30
Student/Concession $10
TOTAL MEMBERSHIP FEE PAID: $.............
NAME(S): ……………………………………………………..
ADDRESS: …………………………………………………….
……………….. ………………………………P/CODE: ………
TELEPHONE: ………………………..
EMAIL: ………………………………………………………..
SIGNATURE(S): ………………………………………………
DATE: …../…../…..
