Membership renewal

 OTWAY BARHAM CATCHMENT LANDCARE GROUP

MEMBERSHIP RENEWAL
Subscription - $25 per property
Financial Year 1^st July – 30 June
 
DATE : ________________________

FAMILY NAME : ___________________________________________

GIVEN NAMES OF FAMILY MEMBERS :_____________________________

__________________________________________________________________

PROPERTY NAME : ________________________________________________

ADDRESS : _______________________________________________________

                     _______________________________________________________

POSTAL ADDRESS (if different)  _____________________________________

                                    ________________________________________________

TELEPHONE : (Home)___________________(Business)___________________

                           (Mobile)__________________

FAX : _______________________________

Email :_______________________________

 
Membership Subscription Paid    Cheque / Cash

     Date:______________________

 
We agree to abide by the Constitution / Rules of the Otway Barham Catchment Landcare Group

Signed _______________________________

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All properties using the services of the Southern Otways Landcare Network (SOLN) must be a fully paid up member of one of the four Landcare Groups which make up the Network

Apollo Bay Landcare Group
Horernvale/Glenaire Landcare Group
Otway Barham Catchment Landcare Group
Wongarra Landcare Group
 
 
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Correspondence to:
The Secretary
Otway Barham Catchment Landcare Group
Simon Pockley, 60 Bridge Street, Northcote Vic 3070
Telephone: Mobile: 0418 575 525

   Email: simonpockley@gmail.com