Membership Application Form

New Member Application

I or our community group wish to Join CROWAG Inc.

Community Organisation (if applying on behalf of an Affiliate group.)

Contact email address here

First Name

Last Name

Phone

Street Address or PO Box No.

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Select Member Type

Incorporated Organisation - $70.00

Unincorporated Organisation - $40.00

Individual - $20.00

Concession/Student/Youth (18 +) - $10.00

By lodging this form to CROWAG you acknowledge and agree to be bound by the model rules of CROWAG Inc. shown on its web page - www.crowag.org and agree to receive notices by email. Application is not valid until payment received by CROWAG.

Membership fee/donation payable to Combined Residents of Whitehorse Action Group (CROWAG) Incorporated.

EFT - BSB - 633 000, Account Number – 163791353 – include name or initials as reference.

Thank you for submitting your application. It will be considered at the next CROWAG committee meeting. Note: Payment must be made before membership approved.