New Member or Membership Renewal? (Please tick): New Member Membership Renewal
Full name:			Email address:
Address:			Postal address (if different):
Home Phone:			Mobile phone:
Type of Membership: (Please tick box)
1. Annual Membership $15.00
2. Donation $
Donations will assist in the developmental activities of Raptor & Wildlife Refuge of Tasmania Inc.
Please tick here if you would like your newsletter to be e-mailed to you instead of posted.

Preferred Payment Options:

Direct deposit:
Bank name: MyState Financial Credit Union of Tasmania
BSB Number: 807007
Account Number: 51391725
Account Name: Raptor and Wildlife Refuge

Note: If you are paying by direct deposit, please either scan and e-mail this form and your receipt to craig@raptorrefuge.com.au; or mail to the address below.

Cheques:
please make out to Raptor & Wildlife Refuge Of Tasmania Inc.

If you are paying by cheque, please complete the details on this form and then mail this with your payment to:

RAPTOR & WILDLIFE REFUGE OF TASMANIA INC
CRAIG WEBB
PUBLIC OFFICER
PO BOX 108
KETTERING TASMANIA 7155

Applicants Signature:

Members will receive a periodical newsletter on the plight of Tasmanian endemic raptors and native wildlife. It will also detail the highlights of a behind the scenes look at what Raptor & Wildlife Refuge of Tasmania Inc. has achieved. As a member of an incorporated association, you will also receive invitations to Annual General Meetings (attendance is optional).
Members are also invited to an annual open day & BBQ, where every one can meet and discuss issues affecting our community. Being a member of the R&WR of T Inc, you will have the satisfaction of knowing that you are helping Tasmanian threatened species.