Application for Membership form - WYONG FAMILY HISTORY GROUP Inc

WYONG FAMILY HISTORY GROUP Inc

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APPLICATION FOR MEMBERSHIP RENEWAL

Single membership $45.00
Family membership $55.00

July 2024 - 30 June 2025

Personal information
Please enter your Membership Number,Name, Age Bracket and how you will pay.
If any of your details have changed please enter them in the required boxes

MEMBERSHIP NUMBER *

Title *

Mrs Ms Miss Mr Other

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Postal Address (if different) *

Line 1

Line 2

City

State

Zip Code

Country

Contact phone number (s) *

Mobile phone number *

Email *

Past/Present Occupations *

In Case of Emergency Contact Name and Phone Number *

I would be willing to help with *

Research room assistant (training provided) Library room helper Data collection Fund raising

AGE BRACKET Reqired for our Personal Accident Voluntary Workers Policy, please click appropriate age bracket/s. *

10 - 50 51 - 70 71 - 85 Over 86

SUBMIT THIS FORM THEN PROCEED TO PAYMENT

For all new members, a new members kit will be available for pick up along with your membership card.

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(c) Wyong Family History Group Incorporated 2023
Contact WFHG for website enquiries / ph: +61 2 4351 - 2211