MEMBERSHIP APPLICATION FORM Name * First Name Last Name Address Phone (###) ### #### Email Date MM DD YYYY Proposed By Seconded By Membership Types Single $20 Couples $30 Junior (Under 15) $10 Payment can be made by Cheque or Direct Debit Albany Orchid Society, BSB 036 - 168, Acc No 216045 Cheque to be posted to - Albany Orchid Society, PO Box 1982, Albany DC, 6331 Giving your name as the Reference Number You may alternatively bring the completed form and pay at one of our monthly meetings. Committee Consideration This applicant was accepted as a member of the Albany Orchid Society on... Copies to President Secretary Treasurer Newsletter Editor Thank you! Or Download Membership Application Form
