TRARALGON AND DISTRICT HISTORICAL SOCIETY INC
Membership Application Form

You can join the Traralgon and District Historical Society  now, and participate in the work of preserving our history. Membership includes posted copies of the Bulletin, published four times a year.
 Please print out  this membership application form, complete it, and forward it with your remittance in an Australian dollar cheque, or bank draft in Australian dollars to:

The Secretary
TRARALGON & DISTRICT HISTORICAL SOCIETY INC.
Post Office Box 697
Traralgon Vic. 3844
Australia

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Please  "X"  the box below to indicate which category of membership you require:

chkbox.gif (127 bytes)   Ordinary Member - Australian   $20.00


chkbox.gif (127 bytes) Concession (Pensioner, Student) Australian $15.00

 
Your name:_______________________________________________

Address:   ________________________________________________

                  ________________________________________________

                 _________________________________________________

Postcode/Zip ____________________

Your email address: (Optional) __________________________

 

Thank you for your interest in the work of the Society.