Membership Application
MIRBOO & DISTRICT HISTORICAL SOCIETY INC.
APPLICATION FOR MEMBERSHIP
Annual Membership Subscription
(August to July)
Single $20.00 per year
Couple $30.00 per year
NAME:
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ADDRESS:
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...................................................................POSTCODE:.........................
EMAIL ADDRESS:
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PHONE:
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NEW MEMBERS ALWAYS WELCOME
ALL CORRESPONDENCE TO:
Mirboo & District Historical Society Inc.
P. O. Box 1,
MIRBOO NORTH VIC 3871
