Membership Application

Your title
Dr.Mr.Mrs.Ms.Other

First name

Surname

Organisation (for Corporate/School members)

Street number and name

Suburb

Postcode

Contact phone number

Your email

Membership Type/Fee (please select)
Corporate – $275.00Individual – $35Family – $40.00School- $100.00

How did you find out about us?
Internet searchIntroduction from a current memberSocial mediaEvent attendanceOther (please specify in Comments section below

Comments

Payment Options:
1/ deposit under email advice to AJS Bank account at:
BSB: 014002 | Account: 253034524

2/ to pay via credit card, please call Taeko on 07 3292 7619 ( please do not email credit card details).

Following payment we will contact you to confirm your membership.

(Please note: The AJSQ is a registered not-for-profit organisation and not registered for GST)

Note: If you are a Full Time tertiary student, contact us regarding ‘Student Registrant’ status.

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