APPLICATION FOR MEMBERSHIP
The Braidwood & District Historical Society Inc.
186 Wallace Street, PO Box 145, NSW 2622
Telephone (02) 48422310
Email: help@braidwoodmuseum.org.au
Name _______________________________________________________________________________
Address ____________________________________________________________________________
_________________________________________________________________________________
Phone __________________ E-mail ______________________
Subscription Fee $10 per person or $15 per family.
Paid Cash_______or Cheque______
I HEREBY APPLY TO BECOME A MEMBER OF THE BRAIDWOOD AND DISTRICT HISTORICAL SOCIETY INC. I AGREE TO BE BOUND BY THE RULES OF THE SOCIETY.
______________________________________________________________________________________Date Signature of Applicant
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