APPLICATION FOR MEMBERSHIP

186 Wallace Street Braidwood NSW 2622

PO Box 145 Braidwood NSW 2622

Phone: 02 4842 2310

Email: help@braidwoodmuseum.org.au

www.braidwoodmuseum.org.au

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 Membership Fee:  $10 Single   or    $15 per Family   PLEASE CIRCLE

 Paid: Cash…………..……Cheque…………………….Direct Deposit………….

Direct Deposit:  Bendigo Bank  BSB: 633-000         Account: 132233354                  

Account Name: Braidwood & District Historical Society

I HEREBY APPLY TO BECOME A MEMBER OF THE BRAIDWOOD AND DISTRICT HISTORICAL SOCIETY INC. 

I AGREE TO BE BOUND BY THE RULES OF THE SOCIETY. 

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