Ozquilt Network 2020 Membership Form

Ozquilt Network Membership Form 2020
The membership year runs from 1 January-31 December 2020. All new and renewing members must complete an membership form regardless of method of payment.
Contact Details
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Post CodeCountry
Phone Number

Area CodePhone Number
E-mail
Status
Check any information you DO NOT PERMIT Ozquilt Network to publish to other members
Website
Blog
Facebook Artist Page
I request official notices (eg notice of AGM) by e-mail only.
Membership Fee
Membership Fee
Payment by
Payment by Credit Card
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OZQN Full membership 2020$40.00 AUD

OZQN Student membership 2020$20.00 AUD

Total $0.00 AUD
OZQN PREFERS PAYMENT BY DIRECT DEPOSIT BSB:033 602 Acct#:13 6213
(Please include your name and the letters “MBS” in transaction description).

Payment may also be made by:
- credit card (via PayPal): no PayPal account required; OR
- cheque payable to Ozquilt Network Inc and mailed to PO Box 753 WANGARATTA VIC 3677.
Supporting Information
Age Range
Arts Practice
Many volunteers work together to make Ozquilt Network happen. Are you willing to assist in some way (eg exhibitions, functions, subcommittees, working parties)?
If yes, are there any special skills that you have that might be helpful to Ozquilt Network?
New Members: How did you hear about Ozquilt Network?
Comments
By submitting this form, I agree to be bound by the rules of Ozquilt Network Inc.
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Ozquilt Network Membership Form 2020