Please enter your contact details

We are required to maintain a current membership register, because we are an incorporated society.

Please enter your details so that we can ensure that our records are correct.

They will be kept private and only a few committee members will have access to them. They may be forwarded to the Registrar of Incorporated Societies, but only if they require us to do so.

Required fields are marked with an asterisk (*).

Given name(s)

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* 1. Given name(s)

Family Name

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* 2. Family Name

Postal Address

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* 3. Postal Address

Phone numbers

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* 4. Phone numbers

Email address

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* 5. Email address

(Optional) Please change the way I receive my monthly Phoenixine, to

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* 6. (Optional) Please change the way I receive my monthly Phoenixine, to

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