Membership Application Form

Please print this document , and complete the details and post to The Membership Officer, 10 Darlington Street, Sturt, SA 5047

Alternatively, select the template below and copy and paste it into an email, add all details, and send to membership@kipioneers.org

Payment can be made via EFT to

Westpac BSB 035-044, Account No. 157 659 (Please include your name as reference in the transfer)

or by cheque to the address above.

TEMPLATE FOR EMAIL (Please also use for any changes in details if you an existing member).

Name/s:

Address:

Postcode:

Email:

Phone:

Mobile:

Family/Ship (if applicable):

K.I. Ancestors (if applicable):

Type of Membership (Individual ($15)/Couple $20) /Student (n/c)

Amount paid:

Donation :

Paid by EFT / Cheque