ACT Rogaining Association 2012 Membership Application

Renewing Members - no need to use this Web Form

Existing members can renew their membership by simply paying the fee, either by BPAY or by cheque. You can search for your CRN using the form below. If you need to update your details contact the membership secretary by email to Julie Quinn: membership@act.rogaine.asn.au.

If joining as part of an event entry - do not use this form

Please use the "with event entry" membership form instead

New Members (or members renewing after a long lapse in membership)

This form sends your membership details to the membership secretary of the ACTRA. Your membership will become official once your team entry fee is paid in full.

Pay by

• BPay, using the Reference Number and Biller Code provided when you submit this form, OR
• Cheque payable to the ACT Rogaining Association. Post your cheque with a copy of the response to this web form submission to either the event administrator of an ACTRA event which you are about to enter, or to:

         
         ACTRA Membership Secretary
         PO Box 496
         Jamison Centre
         ACT 2614
         

Membership Fees

Membership is by calendar year only; fees are $0.00 for an Adult and $0.00 for a Junior aged 17 years or younger as of 1st January 2012

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Surname
First Name(s)
Postal Address: Street or PO Box
Suburb, Town or Locality
State or Territory
Postcode
Birth Date; DD-MM-YYYY
Email Address
Home Phone
Work Phone
Mobile Phone
Membership Fee
how paid	BPAYCheque
date paid (dd/mm/yyyy)

Please indicate how you would like to assist in either the organisation of events or by being on the committee:

If paying by , you MUST record the Biller Code and Customer Reference Number supplied on the RESPONSE you get when you submit this form. Note that if you are paying your membership with an event entry, you need to use your team's BPAY Customer Reference Number. That is, please do not use the BPAY CRN returned by this form to pay your event entry fees.

Any technical difficulties with the submission of this form, contact webmaster@act.rogaine.asn.au.

 

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