NZSG Dunedin Branch
P O Box 5634
Moray Place
Dunedin 9058
New Zealand


Date - 


I wish to become a member of the above society.

(Please fill in the following)


	Name - 


	Street - 


	Suburb - 


	Town - 


    Postcode - 
    

	Phone - 


	Email - 


    NZSG No - 


	Membership type, per annum (please circle)
	
	Ordinary Member (One member, one newsletter (posted) one idsentity card)   $32

	Ordinary Member (One member, one newsletter (emailed) one idsentity card)  $20

	Joint Member (Two members in one household, one newsletter (emailed) two identity cards)  $49

	Joint Member (Two members in one household, one newsletter (posted) two identity cards)  $37

	Newsleter only Member  Posted   Emailed  $14



	Please find enclosed my Cheque.


	Signed


    Are you willing to enter Project Data in a computer at home in your own time  Yes / No