The Twentieth Century Heritage Society of NSW

INDIVIDUAL/HOUSEHOLD MEMBERSHIP APPLICATION

Individual $45; Concession $25; Household $65; Household concession $35; Commercial $130 (Please download separate form) GST included.
If you have any questions about which category applies to you please call or email us before sending your payment.


Mr/Mrs/Ms/Other..................................................................

Name..................................................................................

Address..............................................................................

......................................................Postcode......................

State......................................Country.................................

Pension/Student No..............................................................

Phone Day..........................................................................

Evening..............................................................................

E-mail ……...........................................................................

Mobile................................................................................

Occupation (optional) ..........................................................

Would you consider assisting the Committee in the
running of the Society? Yes / No / Perhaps

Amount due: $ ....................................................................

Signature...........................................................................

Date.................................................................................

Please attach cheque and post to:

The Twentieth Century Heritage Society of NSW, Inc.
P.O. Box Q1072, QVB Post Office, Sydney NSW 1230, Australia.
Phone: + 61 (02) 9878 2511