MITCHAM VILLAGE ART &
CRAFTS ASSOCIATION INC.
&
MITCHAM HISTORICAL SOCIETY

 

1 Torrens Street,
Mitcham,  South Australia. 5062
Phone/Fax: (08) 8272 4504
ABN  76 040 129 823

                                                  

MEMBERSHIP FORM

   To: The Secretary
1 Torrens Street, Mitcham. SA 5062
Phone/Fax: (08)8272 4504

                                        SURNAME                                        GIVEN NAMES
 Mr/Mrs/Miss/Ms/Other   ...........................................                   ............................................................................................

 Address ..................................................................................................................................................................................
 
Telephone.....................................................    Post Code  .........................     Email   .....................................

 I/We hereby apply for my/our membership/renewal in Mitcham Village Art & Crafts Association Inc. (includes Mitcham Historical Society) and enclose

Membership Fee of $                                        Donation $

Signature                                                                                 Date

 

FEES PAYABLE           Family             $25                  Please indicate particular interest in:
                                      Individual         $15                  *Mitcham Historical matters
                                      Pensioner       $5                    *Art & Craft matters
Student (secondary or tertiary)             $5