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Application form

 


The Malacological Society of Australasia

Methods of payment

The Application form, which must accompany payments from new members, lists current subscription rates.

Within Australia:
Either : Payment by personal cheque, made payable to "The Malacological Society of Australasia Ltd" ;
Or : Payment by one of three credit cards listed below by completing the authorisation below.

Outside Australia:
Either : Payment by bank draft in Australian dollars;
Or : Payment by Visa, Mastercard or Bankcard by completing the authorisation below;
.


Name: 

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Address: 

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Post Code: ....................................


PLEASE COMPLETE CREDIT CARD  AUTHORISATION

[ ] BANKCARD
[ ] VISA
[ ] MASTERCARD

Card number

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Signature

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Expiry date:

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Name (as on card)

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Postcode

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Amount in $(AUD)

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Signature

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