Membership Application

Application for Membership/Membership Renewal

If you are human, leave this field blank.

Please choose the option that applies:

I would like to join AFCA as a member group

I am renewing my AFCA group membership

I would like to become an individual AFCA supporter

Name of Organisation

Name of Contact/Supporter *

Address *

Phone (work)

Phone (mobile)

Email address *

Membership Fees

Annual membership fee (if less than 15 members) - $20

Annual membership fee (small organisation) - $50

Annual membership fee (large/national organisation) - $100

I would like to make a one-off donation

Additional donation group members (please specify amount below)

Supporters donation (please specify amount below)

One-off donation amount - $

I would like to make a regular mothly donation to assist the work of AFCA

$10

$20

Other (please specify amount below)

Monthly donation amount - $

I am paying by:

cheque

funds transfer

For direct funds transfer please deposit in: Australian Forests and Climate Alliance Inc, Bank Australia, BSB/Account #: 313-140 12167081

I would like to volunteer to help AFCA

yes (please provide details below)

Volunteer's Name

Volunteer's Phone Number

Skills or resources to share