Proportional Representation Society of Australia (Australian Capital Territory)

MEMBERSHIP APPLICATION FORM

Telephone +614 0409 6403	www.prsa.org.au
	PO Box 4687, KINGSTON ACT 2604

Prospective members might be interested in joining the Australian Capital Territory Branch of the Proportional Representation Society of Australia. By joining the Branch you automatically become a member of the PRSA, which works to have committees, municipal councils, parliaments etc. elected by proportional representation using the single transferable vote (PR-STV).

There are Branches of the Society in four States and the ACT. Your membership and, if you also wish, your involvement in conveying our point of view to Governments, "Letters to the Editor", etc. would be greatly appreciated. Members will be notified of the time and place of our Annual General Meeting, and will receive emails about PRSA activity. 

To the Treasurer, ACT Branch, Proportional Representation Society of Australia 
PO Box 4687, KINGSTON ACT 2604: 

I hereby apply for membership of the PRSA (ACT) in the category ticked in a box below, and attach my cheque accordingly: 

Ordinary Annual Membership (from 1st July to 30th June)	$15.00
Ordinary Annual Membership (from 1st January to 30th June)	$7.50
Life Membership	$200.00
Donation to PRSA (ACT)	$..........
TOTAL PAYMENT	$..........

Signed	Date	20....
Mr/Mrs/Miss/Ms/Dr
Address	Postcode
Telephone (Private)	Telephone (Business)
Fax (Private)	Fax (Business)
e-mail address	Mobile telephone