MEMBERSHIP RENEWAL

WA Rangers Association (Inc)

PO Box 334

North Beach 6920

WESTERN AUSTRALIA

Tel: (08) 9448 7565    Fax: (08) 9203 7565

Fees are $50 for one year membership (2010) or $120 for three years (2010-2012)

Please complete this form and mail, fax to WARA, cheque or money order’s should be made payable to WA Rangers Association Inc.

EFT to Acct No 06 6507 10134200- Please place membership number in Reference field-- 

 

SURNAME _______________________________Mr / Mrs / Ms   Membership number ______

                         (Please print)

FIRST NAMES_________________________________________________________

ADDRESS_____________________________________________________________

__________________________________________________POST CODE_________

CONTACT  DETAILS

 WORK:  Phone_____________________________________

                Mobile ____________________________________                                                                      

                Email______________________________________

 

HOME (all optional):

                Phone_____________________________________

                Mobile_____________________________________

Email______________________________________

 

Minute and newsletter delivery will be

via e-mail

Home□

Work □

Both  □

Please tick

EMPLOYER_______________________________ (Name of Council / Organisation)

POSITION / TITLE_________________________ (Senior Ranger / Ranger etc)

                                                                                   

SIGNATURE________________________________________DATE_______________

OFFICE USE ONLY

MEMBERSHIP CARD __________ RECORDS UPDATED   _________                                             

Fee Paid       $50.00   Exp 2010

                      $120.00 Exp 2012