(Please print, fill in and mail - details at bottom of page)
New membership is $20.00 per person
Renewal is $10 per annum
Current membership is over 200 - Our success relies on your support!
Renewal ($10) __ New member ($20) __
Owner __ Builder __ Trade __ Patron __ Architect __ Other __ (please tick where applicable)
Name ...................................
Street/PO Box ...............................................................
Suburb .................................
P/Code .................................
Ph/Fax ..................................
Mobile ..................................
Email ...................................
Cheques payable to:
Nillumbik Mudbrick Association
PO Box 385, Eltham, Vic, 3095
Receipts will not be posted unless requested
