Application for Membership

You can help save our precious Brush-tailed Rock-wallaby species by becoming a valued member of the Waterfall Springs Conservation Association. Your support will make a difference!

Applicant Details:

Name of Applicant:
Telephone:
Email:
Postal Address: (not a PO Box)
Membership Choice:	Individual Membership - $10 Annual Fee Group Membership - $20 annual fee Corporate membership - $100 Annual Fee

I hereby apply to become a member of the above mentioned incorporated association. In the event of my admission as a member, I agree to be bound by the rules of the association for the time being in force.

Payment:

Payment Method:

Cheque
Money Order
Online

Note for ONLINE payment: After submitting your application please proceed to the Online Donation page using the "DONATE" link on the following page.

For cheque or money order: Please print this page and send with payment. Please make cheques payable to
WATERFALL SPRINGS WILDLIFE SANCTUARY

Post to:
RMB 2394A, Kyola Road
KULNURA NSW 2250
Australia

Renewal:

Please send me a renewal at the end of my 12 month adoption.

•