TREAT MEMBERSHIP APPLICATION / RENEWAL FORM

Subscription is $15 per annum per household. Mail to: TREAT, PO Box 1119, Atherton, QLD 4883

Enquiries: Email TREAT Secretary Doug Burchill (dcburchill@bigpond.com)


PRINT-FRIENDLY: CLICK ‘FILE, PRINT-PREVIEW, PRINT’ ON YOUR TOOLBAR


NAME
POSTAL ADDRESS
POSTCODE
PHONE NO.
FAX NO.
Email Address (where applicable)
LOCATION OF PROPERTY (if not the same as above)
Subscription Amount: $15.00 X number of years membership = $
Date of direct deposit** (if applicable)
Renewal-Yes/No
New Membership-Yes/No
Donation Amount: $

**If you wish to pay your membership by Direct Deposit the details are: Bendigo Bank, BSB 633-000, Account Number 122 520 976, please provide your name as reference for the Direct Deposit, and complete this page for our records and send to TREAT, or send the above details via email.

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