2012 membership form by stariya

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									                                LEGAL EDUCATION TEACHERS ASSOCIATION OF SOUTH AUSTRALIA Inc

                                   MEMBERSHIP APPLICATION FORM 2012
                                                             TAX INVOICE
                                                          ABN 14 852 335 677
                                       LETASA is a not-for profit organisation and does NOT charge GST

PAYMENT OPTIONS – Please select one.
    Credit Card                             EFT                                   Cheque
               Regardless of payment option Membership form must be sent to Membership Secretary
                         Please send notification of EFT to the Membership Secretary with 2012 Membership form.


                                                Please complete ALL parts fully
        Family Name

        Given Name(s)

        School/College/Workplace

                         Whenever possible Legal Brief will be sent to a member’s workplace,
                                  particularly if on the courier as it reduces cost.

        Address you wish legal brief to be sent


                                                 Postcode                         Work Telephone:

        Email address

    Members MUST notify the Membership Secretary of any change of address to guarantee your regular copy of Legal Brief.

                                           Membership fee: please circle the appropriate one.
                   Individual $60                     Institution      $110               Pre Service Teacher           $20
                                                  Make all cheques payable to LETASA
For Credit card payment:
        Bankcard / Mastercard / Visa                             Name on card:
        (circle the appropriate one)

        Card No:                                                                            Amount: $

        Expiry Date:            ___ / ___                       Signature:


   An Electronic Funds Transfer can be made into:                                SEND THIS APPLICATION FORM AND YOUR
Account Name: Legal Education Teachers Association                                  PAYMENT/EFT NOTIFICATION TO:
                  of South Australia                                                               Paula Hensing
               BSB Number: 065 131
            Account Number: 1006 4914                                                   Cabra Dominican College, PO Box 57
Reference: School Name (Institutional Membership)                                              MELROSE PARK 5039
                          or                                                               Ph: 81792400 Fax: 8272 9810
     Member’s Name (Individual Membership)

LETASA POLICY: All 2011 financial members will receive their copy of Legal Brief in Term 1, 2012. However, if your renewal is not recorded by the
                  end of Term 1, 2012 with the Membership Secretary you will not receive the No. 2 issue in Term 2.

								
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