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Membership Application Form
Complete this form and post it with your subscription to:
The Treasurer,
Wellington Southern Bays Historical Society Inc.,
31 Melbourne Road
ISLAND BAY, WELLINGTON
I/We wish to join the society and enclose the annual subscription.
$15 individual - $20 family
Corporate, $30
Amount enclosed ............................ Name(s) given names(s) and family name(s)
Postal Address:
Telephone (home): Email address (if any): Would you be prepared to assist the Society in any other way?
If so, please state the area of your choice. e.g. researcher, assist/archives, newsletter, help with socials, publicity,
Other:
Thank you