First Name | Surname | ||
K-CHS Member | Address only required if changed | ||
Street or POB
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City/Suburb
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State
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Postcode
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Phone | Mobile | ||
Enter 'None' if you have no email address | |||
Note (optional) | |||
Year of Birth (req'd for insurance) |
Millstone by post as well as by email |
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Second person (for family membership) * only if different from first person | |||
First Name | Surname | ||
Year of Birth | Mobile * | ||
email * |
Single Adult Membership | @ $20 ea | ||
Family Membership | @ $30 /family | ||
Single Senior Membership (70 and over) | @ $12.5 ea | ||
Senior Family Membership (either over 70) | @ $15 /family | ||
K-CHS is not registered for GST | TOTAL | ||