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"Accountable Representation for the
People" Now that you have read about the reform society why don't you join and assist us in breaking the domination of the major political groups. Just print this page and complete it and return it by mail. Forward to Secretary Australia Reform Society PO Box 64 Mandurang Vic 3551 REQUEST FOR MEMBERSHIP /
MEMBERSHIP RENEWAL
PLEASE
RETURN THIS FORM WITH YOUR PAYMENT
Name:
________________________________________ Address
_______________________________________ Town/city __________________ Postcode ___________ Phone Daytime________________AH____________________
Email Address
_______________________@________________________
If
renewing; MEMBERSHIP
NUMBER: ____________ CURRENT
RENEWAL DATE: __________ ____ FULL MEMBER $20.00 _____PENSIONER / STUDENT $10.00
We
would appreciate any further monies that you wish to enclose as a donation. PLEASE
FIND ENCLOSED PAYMENT FOR THE AMOUNT OF:
$ .00
Did you know: you can find us on the World Wide Web at www.reform.org.au
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