PORT MACQUARIE HISTORICAL SOCIETY INC.
Application for Membership

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Application
  I hereby apply to become a member of the Port Macquarie Historical Society Inc. and agree to abide by the rules and actively support the aims and objectives of the Society and its constitution.
  Signed (Applicant) 
Date
  I, , being a member, hereby nominate the above Applicant for membership of the Society.
  Signed (Nominator) 
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  I , being a member, hereby second the Nomination of the above applicant for membership of the Society.
  Signed (Seconder) 
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Areas of Interest
 
Please complete this form. You can then either send it to the society via email or print and post or fax it to us.
If you want to keep a copy of the completed form for your records, print a copy before you send it to us.
  Port Macquarie Historical Society Inc.
P.O. Box 82, Port Macquarie NSW 2444
Phone: 02 6583 1108 Fax: 02 6584 7651
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Date Membership Accepted Membership card sent
Date Letter Sent