On-line Membership Form

Membership Form - online version

Vertical Divider

Central Blue Mountains Garden Club Inc.
Membership Application Form

Please hover your mouse over the ? (or tap) to reveal instructions if you need them.

Full Membership - $30 ( $25 annual subscription + $5 name badge)

* Indicates required field

PREFERRED PAYMENT METHOD *

YOUR NAME *

First

Last

Email *

Address *

Phone number *

Emergency Contact Details of relative or close friend *

Special Interests in the Garden *

Would you like to receive the Newsletter ? *

How did you hear about us ? *

I consent to my image being used on our Facebook page. *

I consent to my image being used in the CBMGC newsletter *

I agree to be bound by the rules and Constitution of the Central Blue Mountains Garden Club.

Signature *

OFFICE USE ONLY *

Nominated by: *

Seconded by: *

Date Approved *

Paid Date *

Badge given date *

Welcome letter emailed date *

Submit form