Mirboo and District Historical Society Inc MEMBERSHIP
APPLICATION FOR MEMBERSHIP
Annual Membership Subscription
Single $20 per year
Couple $30 per year
NAME: ..........................................................................................................
ADDRESS:
..........................................................................................................
EMAIL ADDRESS:
..........................................................................................................
PHONE:
..........................................................................................................
ALL CORRESPONDENCE TO:
The Secretary,
Mirboo & District Historical Society Inc.
P. O. Box 1.
MIRBOO NORTH VIC 3871
