Membership Application Form

Application for Membership of A Progressive Christian Voice (Australia) Inc.

I, name (required):

address (required):

email (required):

desire to become a member of A Progressive Christian Voice (Australia) Inc.

I agree that communication with me can be by email (required):
YesNo

Member category (required):
Waged $20Unwaged $10Student $5Group $25

Payment method (required):
Direct depositCheque

I support the purposes of the association and 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.

To complete my application, I understand that I need to agree to make payment immediately and indicate this by ticking this checkbox.