Membership

Membership Form

To become a member of Urban Ecology Australia, or renew your membership, fill out this form and send with appropriate fee to: Urban Ecology Australia, 105 Sturt Street, Adelaide, Tandanya Bioregion, South Australia, Australia 5000.

Date:
Name:
Company/Organisation:
Address:
Phone:	Fax:
Email:
Type of Membership (please tick) Ordinary membership $40 yearly Concessional membership $20 yearly Sustaining membership $20 plus $10 monthly Life membership $250 Corporate membership By negotiation
I enclose a cheque/money order for $......... (payable to Urban Ecology Australia Inc)   Please charge $............... to my Bankcard/Visa/Mastercard   Card no. ............./............../............/.............. Expiry date ........./......... Cardholder’s name:   Signature: ...............................................