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MEMBERSHIP FORM - THE JOHN FARNHAM OFFICIAL FAN CLUB

Name :(first) _______________________________________________

         (surname)____________________________________________

Address : _________________________________________________

Postcode: _______________

Phone : (H) (___) ________________) (W) (___) _________________

(M)_________________________

E-mail address : _____________________________________________

DOB : ____________________ M/F : _________

NEW MEMBERS
Annual membership fee:
$20.00 Australia $30.00 Residence outside Australia

PAYMENT DETAILS
… I enclose a cheque/money order for $____ made payable to Voice Events
… I have direct deposited into Voice Events Bank Account
    BSB: 033 398 Account: 125022 (clearly note your name on transaction)

Overseas members may pay via paypal to sue1603@bigpond.net.au

PASSWORD
You will need to supply a user name and password (case sensitive)
as newsletters are delivered electronically
.

User Name ______________________

Password ________________________

RENEWALS
If your membership has lapsed and you are renewing outside of 3 months please add a further $10 administration fee.


Send completed forms to:
Voice Events PO Box 1220 North Fitzroy VIC 3068
or email voiceevents@johnfarnham.info


please circle
RENEWAL

NEW MEMBERSHIP