PICO Membership Application Form

PICO Membership Application

To become a friend or apply for membership please complete this form.
Community members who are interested in staying up to date with the project can become Friends of PICO at no charge, and you will receive updates and invites to community events at the orchard and garden.

To become a member you are required to complete the below form, attend an induction session and agree to a minimum commitment to this community project.

Member information packs can be downloaded from here: Member Induction pack (PDF 6MB)
Membership Type
prevnext( X )
Individual Membership (Annual)$25.00AUD

Family Membership (Annual)$45.00AUD

Friend of PICO$ FreeAUD
Date

DayMonthYear
Name*

First NameLast Name
E-mail*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone / Mobile number*
Activities that interest you

Nursery activitiesGeneral gardeningCompost worm farmOrganising eventsGarden toursAdministrationMail outsArticles / mediaFacilitating workshopsAssisting with school groupsArts projectsOther
What experience can you bring to the group?
What would you like to gain from volunteering with the orchard?
How often would you like to participate?

Once or more a weekOnce a fortnightOnce a monthSpecial projects / events
All members are required to complete the site induction and this member registration form before you can access the site and participate in any activities associated with the community orchard.
Please tick:*

As a member I agree to adhere to the community orchard safety guidelines & terms of reference outlined in the induction pack.I understand my responsibilities as a member of PICO.Yes I would like to become a member ($ fee payable via bank transfer - see below)

Membership Payment:

Please send your membership payment to the following bank account details:

(Please use your name as payment reference)

Bank details:	Bendigo Bank
Account Name:	PICO
BSB:	633000
Account #	150130045
Reference:	'Your name'

Privacy Statement

PICO and Westernport Water are collecting the information requested on this form for the purposes of recording community orchard member details. This information will be handled in accordance with the Information and Privacy Act 2000. For a copy of Westernport Water’s privacy charter which describes in more detail how personal information may be used, or how to access your personal information, please visit www.westernportwater.com.au/privacy or contact 1300 720 711.
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PICO Membership Application

Privacy Statement