Membership Form

Current Details on File

Institution Name:

 

License Number:

Contact Name:

Title:

Institution Location:

Postal Address:

Phone Contacts

Work Number:

Mobile Number:

After hours or Home Number:

Other Contact Details

Fax Number:

Email address:

Membership Status:

Revised Details if Necessary

Institution Name:

 

License Number:

Contact Name:

Title:

Institution Location:

Postal Address:

Phone Contacts

Work Number:

Mobile Number:

After hours or Home Number:

Other Contact Details

Fax Number:

Email address:

Membership Status:

Please indicate your consent of the release of the above information to other members only;�

(Please Circle)  YES � orNO

Membership Categories

Associate $55 Full $220
Membership Category Details

Any person, partnership or corporate body or any other body which does not conduct a Fauna or Marine Park for Commercial, educational or scientific research purposes may be given membership under this category at the discretion of the Executive Committee.� Associate membership doesn�t entitle voting rights and shall not be permitted to hold any office in the Association

Membership Category Details

Any person, partnership or corporate body, or any other body who conducts a Fauna or Marine Park for commercial, educational or for scientific research purposes, shall be eligible as a Full member of the Association.� Full membership entitles voting rights and the opportunity to hold any office in the Association.

Please find enclosed cheque/money order for sum of $55 / $220 (cross out incorrect statement) being for Associate / Full (cross out incorrect statement) membership to the NSW Fauna & Marine Parks Association.  

Please make Cheque/Money order Payable to the NSW FAUNA & MARINE PARKS ASSOCIATION INC. and send completed application with Cheque/Money order to:

NSW Fauna & Marine Parks Association Inc.
Treasurer

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