Membership

"*" indicates required fields

$15 Single Membership $30 Double Membership.

Member Name*

First Last

Postal Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Enter Email Confirm Email

Phone*

Please return this form to the GCA and remit by:

Cash to the Visitor Centre or Community Library OR
Cheque posted to GCA, PO Box 1101 Guilderton WA 6041 OR
Bank Deposit to GCA at the Bendigo Bank:
BSB: 633000
Account: 145418018
Reference: Please use your surname as the reference