membership application form 2010

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					THE BOTANICAL ART SOCIETY OF AUSTRALIA INC.
                         Reg No Y2951408 ABN 14 809 478 761


                     MEMBERSHIP APPLICATION
NAME………………….……………………………………………………………………
       First Names         Surname

MAILING ADDRESS ………………………………………………………………………..

………………………………………………Postcode……………….............

TELEPHONE ……........................ MOBILE ………………………..FAX …………….........

EMAIL ………………….………………… WEBSITE ………………………………………

PROPOSER …………………………………… SECONDER
…..……………………………

APPLICANT’S SIGNATURE ………………………………… DATE …………………….

SUBSCRIPTION:                    $35 per year        * The Botanical Art Society (BASA)
INITIAL JOINING FEE:             $10                 Newsletter contains information
                                                     about botanical art exhibitions,
Annual membership renewal                            profiles of established artists,
due 1st July each year and                           exhibition and book reviews,
includes 4 BASA newsletters *                        notification of art workshops, BASA
                                                     group outings and activities.
                                 $...............
DONATION: (non-obligatory)                           Additional mailouts of future events
Donations over $5                                    are sent out regularly. General
are tax deductible                                   meetings are held quarterly at the
                                                     Mosman Art Gallery and
                                                     Community Centre. These meetings
Cheques should be made
                                                     feature a guest speaker and offer
payable to Botanical Art
                                                     the opportunity for a convivial
Society of Australia Inc, or
                                 $................   evening and light supper with fellow
BASA
                                                     artists. Guests and prospective
                                                     members are always welcome.
                         TOTAL



Method of Payment:     □ Cheque □ Money order □MasterCard □Visa
Name…………………………………..Cardholder’s Signature......………………………………………………………………
MEMBERSHIP BOOKLET:
A membership list with contact details is to be distributed to members annually. The
purpose is to facilitate contact between members and to enable them to become
better acquainted with fellow members in their region. In consideration of privacy, you
may choose to be excluded from the list by marking the box below.

□ Please exclude my name and contact details from the BASA Membership Booklet.

Please send this completed form and payment to:

Mr Peter Thompson
Membership Secretary
Botanical Art Society of Australia Inc
PO Box 499
TURRAMURRA NSW 2074
AUSTRALIA



Enquiries contact Clare Benson on (02) 9427 5722

				
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