Copy the text below into a new email, complete it and send it to info@esperanto.org.au with the subject line “AEA membership application”.
Hello,
I wish to become a member of the Australian Esperanto Association. Below are my details.
1. First name: ___________________
2. Family name: ___________________
3. Address (inc. postcode): ______________________________________
4. Telephone number(s) (inc. area code): ___________________
5. Email address: ___________________
6. Skype name: ______________________
7. I agree to make the following public:
(Delete the lines that don't apply)
- Telephone
- E-mail address
- Skype name
8. Type of membership:
(Delete the lines that don't apply)
- Ordinary full member $40.00
- Full member – concession $35.00
- Lifetime member $600.00
- Lifetime member – age concession over 65 years $300.00
(My date of birth: __/__/____)
- Overseas member $40.00
- Overseas member – printed ESK $96.00
- Associate member $20.00
- Family member or Youth member (to 21 yrs) $20.00
- Organisational member $40.00
9. I will pay / have paid by:
(Delete the lines that don't apply)
- Credit card via PayPal
- Direct Deposit: Date: __/__/__; Description: _______________
- Cheque or Money Order
Regards,