AUSTREK
AUSTREK, The Star Trek Fan Club Inc, is a not-for-profit organisation based in Melbourne, Australia. Established in 1976, AUSTREK is the second-oldest Star Trek Fan Club in the world, and the longest running in Australia. It is a social club for people of all ages, from all walks of life who share an interest in the many worlds and incarnations of Gene Roddenberry’s Star Trek. Becoming a member of AUSTREK allows you to become involved with other like-minded people at regular meetings. Activities include costuming, quizzes, trivias, media presentations, conventions and Away Missions. You will also receive our bi-monthly newsletter “The Captain’s Log” with Trek and sci-fi news, reviews, letters, articles, stories, club news, event details and much, much more. AUSTREK Contact Details Phone – 0439 444 901 or 03 9458 3721 (AH) Email – fanclub@austrek.org Web – www.austrek.org Post – GPO Box 5206 Melbourne, Victoria, 3001
(Incorporated Association: A0030794M)
Membership Form – New/Renewal
Please print details. All cheques and money orders are to be made payable to AUSTREK.
Single membership - $30 Family membership - $35 International - $50 AUD Subtotal Grand Total
_______ _______ _______ _______ _______
concession* - $25 concession* - $30
_______ _______
(*Proof of concession required)
Family Name__________________________________________________ Given Names__________________________________________________ Address______________________________________________________ _____________________________________________________________ Date of Birth____________________ Phone No______________________ Mobile No ____________________
Email_________________________________________________________
Payment Method (please circle one)
VISA Bankcard Mastercard Cheque Money order Cash Credit card details: Card Holder’s Name:___________________________________ Card Number: ________________________________________ Expiry Date: ________________________ Amount: ___________________________ Receipt No: Signature: __________________________
How did you hear about us? Please tick one: Internet Other Convention (please give brief details):
Office Use Only Membership No:
Date Received: Date Entered: Concession Card No:
AUSTREK
AUSTREK, The Star Trek Fan Club Inc, is a not-for-profit organisation based in Melbourne, Australia. Established in 1976, AUSTREK is the second-oldest Star Trek Fan Club in the world, and the longest running in Australia. It is a social club for people of all ages, from all walks of life who share an interest in the many worlds and incarnations of Gene Roddenberry’s Star Trek. Becoming a member of AUSTREK allows you to become involved with other like-minded people at regular meetings. Activities include costuming, quizzes, trivias, media presentations, conventions and Away Missions. You will also receive our bi-monthly newsletter “The Captain’s Log” with Trek and sci-fi news, reviews, letters, articles, stories, club news, event details and much, much more. AUSTREK Contact Details Phone – 0439 444 901 or 03 9458 3721 (AH) Email – fanclub@austrek.org Web – www.austrek.org Post – GPO Box 5206 Melbourne, Victoria, 3001
(Incorporated Association: A0030794M)
Membership Form – New/Renewal
Please print details. All cheques and money orders are to be made payable to AUSTREK.
Single membership - $30 Family membership - $35 International - $50 AUD Subtotal Grand Total
_______ _______ _______ _______ _______
concession* - $25 concession* - $30
_______ _______
(*Proof of concession required)
Family Name__________________________________________________ Given Names__________________________________________________ Address______________________________________________________ _____________________________________________________________ Date of Birth____________________ Phone No______________________ Email_________________________________________________________
Payment Method (please circle one)
VISA Bankcard Mastercard Cheque Money order Cash Credit card details: Card Holder’s Name:___________________________________ Card Number: ________________________________________ Expiry Date: ________________________ Amount: ___________________________ Receipt No: Signature: __________________________
How did you hear about us? Please tick one: Internet Other Convention (please give brief details):
Office Use Only Membership No:
Date Received: Date Entered: Concession Card No: