Name in full
Address
e-Mail
Phone
Mobile
Age
Gender
Male
Female
Do you wish to supply a photo for your membership card?
Yes
No
What is your main interest
St. Helena Island
Peel Island
Ft. Lytton
Boggo Road Gaol
Type of membership requested
Full Membership
Affiliated Membership
Corporate Membership
Do you have any specific
questions or comments?
You may pay your membership fees as per the membership fees page or kindly send an email to the Treasurer of your preferred method of payment.
Email the Treasurer