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.