Arthritis Tasmania - Membership form

Arthritis Tasmania Membership form

Please complete this form, print and mail it to us together with your cheque, money order or completed credit card authority to:

Arthritis Tasmania
19A Main Road
Moonah
Tasmania 7009
Australia

Your membership is greatly appreciated and a letter of acknowledgement and receipt will be provided.

*Name (in full)*
Address
Post Code
Contact Phone
Email
Type of arthritis
Type of Membership Subscription Required	Individual membership $28 Concession membership $10 Life membership $330 Professional membership $33 Organisational membership $110
Please PRINT AND MAIL this form as detailed above.

This page was last modified on Thursday, March 8, 2012