Membership Form

Register your support by becoming a member of the Society. Below is a copy of the subscription form that can be printed out and all details entered, then post it to us with a cheque for the correct amount.

Membership runs from 1st July until 30th June the year after.

Use your Mouse or TAB key to fill the form out.
First Name
Last Name
Street Address
Suburb
City
Post code
Phone No.	()
Cell Phone No.	()
Occupation
E-Mail Address
Receive Newsletter by email	Yes No
Type of Membership please (Click one)	Ordinary Member $30 Family Member $40 (2 Adults & 2 Children) Junior Member $15 (under 18)
Age group (Click one)	Under 25 25 - 49 50+
Comments

Payment Details
Payment was made by:	Cash Bank deposit
Bank Deposit details	Account Name: FDSR Account Number: 03-0626-0659376-000 Please use your First name & surname as a reference and return this completed form.

Print this form and post to:

Feilding & District Steam Rail Society Inc
P O Box 197
Feilding

E-mail us at: secretary@steamrail.org.nz

Date: