Current fees are Individual $50, Household $70, Concession $25 and Corporate $220.
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Please print this page now.
Complete the details and then mail to Box K860, Haymarket NSW 1240 or Fax to 02-9905-8787.
Name: ____________________________________________________________ Address: __________________________________________________________ __________________________________________________________________ Postcode: ________________________________________________________ Phone number: ____________________________________________________ Mobile: ______________________________________________________________ Email: ______________________________________________________________ Fax: ________________________________________________________________ Membership category: ____________________ Fees: __________ Donation: _______ |
| Tick payment method: |
Credit card ___ Direct debit ___
Cheque attached ___ Send invoice ___
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| For Cards only: |
Issued by: Mastercard: ____ Visacard: _____ (Only these two please)
Expiry date: _________ Number: ________ ________ ________ ________ Cardholder's Signature: _________________________________ |
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| For Direct Debit only: |
Send your direct debit to BSB 062-006 Account 0090-0623
then email your details to nsma@nsma.org.au
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| For Cheques: |
Please make cheques payable to the Non Smokers' Movement of Australia.
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| For Invoices: |
Just ask and we will send you an invoice.
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The Non Smokers' Movement of Australia.
Current fees are Individual $50, Household $70, Concession $25 and Corporate $220. |