APPLICATION FOR MEMBERSHIP New Members only Send to     The Treasurer, Australian Plants Society Tasmania Inc.                   PO Box 3035, ULVERSTONE MDC, Tasmania  7315                  Australia Name(s)....................................................................................................................................................... ......................................................................................................................................................................                                             (For Household membership include names of all members nominating) Address........................................................................................................................................................ ........................................................................................................................................................................ Postcode...............................Phone...........................................................Fax.............................................. Email............................................................................................................................................. Subscription period 1 year 2 years 5 years Amount paid Regular (Individual) including Organisations $35.00 $66.50 $157.50 *Concession membership (Please check appropriate box below) $31.00 $58.90 $139.50 Each additional adult included in Household Membership (Regular or Concession) $7.00 $13.30 $31.50 Each additional child included in Household Membership (Regular or Concession) $1.00 $1.90 $4.50 **Overseas Member or Overseas Organisation $45.00 $85.50 $202.50 Australian Plants Journal $10.00 $20.00 $50.00 Total Amount Tendered:           $ *Concession subscription rates are offered to holders of a Pensioner Health Concession Card issued by Centrelink or the Department of Veterans Affairs, or of a Student ID Card Please check the appropriate item below if you are eligible for the concession I have a Pensioners Concession Card from Centrelink (   ) DVA (   ); a Student ID Card (   ) **Paid by Bankers Draft in $Australian Please complete the item below: I agree to abide by the rules of the Society and enclose $...................................................Subscription fee. Signature............................................................................................................date............./......../.............