Please enroll me as a member of the Australian and New Zealand Map Society Inc.
Name: ___________________________________________________________
Address: ___________________________________________________________
___________________________________________________________
Country: _______________________ Postcode: _________________________
Email: ___________________________________________________________
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Membership type:
Student (AUD $30.00) __________
Individual (AUD $50.00) __________
Institutional (AUD $50.00) __________
I enclose $ _______________
Please make cheques payable to 'Australian and New Zealand Map Society Inc.'.
(All cheques must be in Australian Dollars and drawn on an Australian bank)
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Payment by Credit Card:
Card type (circle): Bankcard / Mastercard / Visa
Card number: _______________________________________________________
Expires: ___ / ___ Amount Authorized: A$ ___________________
Card Holder Name: __________________________________________________
Signature: _________________________________________________________
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Please print this form out and post it to:
ANZMapS Business Manager,
PO Box 4206,
University of Melbourne, 3052,
Australia.
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