BNT Membership Application

Membership year is from July 1 to June 30. 


Complete the form below and post with your payment to:

The Bicentennial National Trail

PO Box 1196 NERANG QLD 4211

email: order@nationaltrail.com.au

Phone 1 300 138 724 (within Australia)


Name:___________________________________________________________________________

Postal Address:____________________________________________________________________

____________________________________________________________ Postcode___________

Phone (Business): _____________________________ Phone (Home): ______________________

email Address: _____________________________

MEMBERSHIP FEE:
$30 for individuals: [_]      $45 for Family or Club: [_]      Three years (multiply by 3): [_]

If family membership then only one vote allowed and nominated person to be advised.
If club membership then two votes allowed and nominated persons to be advised.

DONATION (Donations $2 and over are tax deductable)
[_] $20    [_]  $50    [_] $100    [_] $500    [_]  Other __________

In partnership with the National Trust of Australia Bicentennial National Trail Heritage Appeal

PAYMENT BY EFT

Bank of Queensland BSB: 12 4001 Account number: 10 285 229 Reference: Please enter your name

Please send email to order@nationaltrail.com.au with receipt of payment details to confirm payment.

PAYMENT BY CREDIT CARD:
Please charge $........... to my [_] Mastercard,    [_] Visa

Cardholder Name: _______________________________________________________

Expiry date (day/month/year): [__][__] [__][__]

My card number is:

[__][__][__][__] [__][__][__][__] [__][__][__][__] [__][__][__][__]

Cardholder's Signature: _________________________________________________

PAYMENT BY CHEQUE OR MONEY ORDER:
Cheque [_]   Money order [_] (Please make payable to Bicentennial National Trail)

I am primarily a [_]walker, [_]horserider, [_]cyclist, [_]donkey packer, other ...............................

How did you find out about the BNT?
Website[_] Word of mouth[_] Magazine or newspaper article[_] Other[_]....................................

All annual membership renewals are due 30th June.  New memberships paid between
January and June provides continuous membership until June of the following year.