Shelter NSW membership form/Around the House subscription form

Tax invoice

Shelter NSW Incorporated
ABN 95 942 688 134
Suite 2, Level 4, 377-383 Sussex Street, Sydney NSW 2000

Annual fees, inclusive of GST
As at 1 July 2009

Membership fees:

For community organisations, individuals and private sector firms

Individual:

• unwaged $11
• waged $39

Organisation:

• small (total annual income of $0-$50,000 as small) $65
• medium (total annual income of $50,001-200,000) $95
• large (total annual income of over $200,000) $120

Subscription fees for Around the House:

For state and local government agencies, and others

Individual: $52
Organisation: $121

Take out a subscription if you want to get Around the House and the Member eBulletin but do not want to become a member of the organisation. Members do not need to subscribe to Around the House and the Member eBulletin; they get them for free as a membership benefit.

Your details

Please tick where appropriate.

__ Yes, I would like to join/renew my membership to Shelter NSW:

__ Yes, I would like to join/renew my subscription to Shelter NSW:

Name:

Organisation (if applicable):

ABN:

Postal address:

Postcode:

Telephone:

Fax:

Email:

Service type (if applicable):

Payment

Please tick where appropriate.

__ I/we enclose cheque/money order made payable to Shelter NSW, or cash, for $ ____________

__ Please charge my credit card:

____ Visa ____ Mastercard, for $ ____________

Card number:

Cardholder’s name:

Expiry date:

Verification no. (CCV):

Signature:

Date:

This form serves as a tax invoice for GST purposes on payment. Please keep a copy for your records.

Consent for receiving information by email

__ Yes, I consent to you sending me information about Shelter NSW activities by email, such as the Member eBulletin.

Please print this form, complete, and fax to (02) 9267 5001; or post with your cheque/money order to Shelter NSW, Suite 2, Level 4, 377-383 Sussex Street, Sydney NSW 2000.

Updated 30-Jul-2009
Shelter NSW