AUSTRALIAN PLATYPUS CONSERVANCY

Friends of the Platypus

Membership Application

Benefits include:

A subscription to Ripples.

Special members’ rates for purchase of clothing, posters, cards, booklets and other platypus materials produced by the APC.

Simply fill in the details below and send to the Australian Platypus Conservancy.

Name:______________________________________(BLOCK LETTERS)

Address:______________________________________________________

Postcode:_______________________Tel No:_________________________

Please note that all prices are in Australian dollars.

Individual Membership ($30 per year)                   ________

Family/School/Non-profit Group ($45 per year)   ________

Full-time Student ($20 per year)                            ________

Business/government dept ($100 per year)                     ________

Overseas (add $10 per year)                                ________

Research Donation* (optional)                                ________

                                                TOTAL             $_________

*Donations of $2 or more are fully tax deductible.

Enclosed is a cheque/money order (payable to Australian Platypus Conservancy)

OR

Please charge my VISA/Mastercard/Bankcard No.

Expiry date:_____________________

Name of Cardholder:_____________________________________

Signed:__________________________Date:__________________

Copy this page and send to:

Australian Platypus Conservancy
Box 22
Wiseleigh VIC 3885
Tel: (03) 5157 5568
Email: platypus.apc@westnet.com.au