If you would like to join GOFRG Inc. please print this page and forward
Geelong One Fire Reconciliation Group Inc.
MEMBERSHIP FORM
P.O. Box 7046
Geelong West, Vic 3218
ABN 79 102 252 830
Inc . No. A0037242T
Annual subscription: $20
Donation: $
TOTAL payment: $
NAME:
ADDRESS:
POST CODE:
PHONE:
EMAIL:
DATE:
If you wish to pay by direct transfer please use the following bank details, and then email this form as a record for the Treasurer. You will then be sent a receipt.
Bendigo Bank
BSB: 633 000
Account Number: 138 666 672
Please enter your name in the reference section so we can trace all payments.
