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Australian National Cockatiel Society Inc Online Membership form *Denotes compulsory field
*Tick Application or Renewal
*Type of Membership Standard Pensioner Student Overseas
*Name:
*Address:
*Suburb: *Postcode:
*State: Queensland Victoria New South Wales ACT Tasmania South Australia Western Australia Northern Territory Other *Country:
Phone No:
Month of Birth: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Email:
Cockatiels kept: Breeding: 0 Under 10 !0 - 30 31 - 50 Over 50 Pets: 0 1 2 3 - 5 Over 6
* I / We hereby apply for membership to the Australian National Cockatiel Society Inc. and
agree to be bound by the constitution, rules, and regulations of the Society.
I understand that as a financial member I am entitled to receive six (6) issues
of the bi-monthly journal per calendar year at no additional cost.
* I am over 18 years of age
(If under 18 then parental consent is required)
Payment method Direct Deposit Cheque Money Order
Bank details will be emailed upon receipt of completed membership form.
Forms will not be processed until payment has been received in full.
Standard $40.00 / Annum Student / Pensioner $34.50 / Annum Overseas $52.00 / Annum All amounts are in Australian Dollars. Membership renewal falls due in December of each calendar year.
To calculate prorata fees please contact the club secretary.
secretary@cockatielsociety.org.au
If paying by cheque or money order please make payable to The Australian National Cockatiel Society Inc
The Secretary A.N.C.S. PO Box 1248 Fortitude Valley Qld 4006