Friends of the Queen Victoria Museum and Art Gallery
New Members form

Fill in your details, print, sign and post to the address below.

Membership is annual and is obtained by completing this form and returning it with the appropriate fees to the address below.

Friends membership fees
Subscriptions paid from 1 January entitle you to membership until 30 June 2010.

Individual Memberships

1 year: ends 30 June 2010

$42.00

Individual Concessions* 1 year

$37.00

3 years: ends 30 June 2012

$126.00

5 years: ends 30 June 2014

$210.00

Family Memberships (2 adults and the children under 18 at the same address)

1 year: ends 30 June 2010

$57.00

Family Concessions* 1 year

$47.00

3 years: ends 30 June 2012

$171.00

5 years: ends 30 June 2014

$285.00

Corporate Group Membership
General Corporate membership $180.00
Premium Corporate membership $520.00

Associate Group membership $47.00
Entitles members to all the Friends’ information services such as quarterly newsletters and monthly correspondence concerning special events, but excludes entitlement to concessional rates for any Museum admission charge.

Distant Individual Membership
$37.00
Distant Famly Membership
$47.00
Entitles members to receive all the membership benefits including the quarterly newsletter but excluding the regular monthly correspondence concerning special events.

* Students over 18, senior citizens, unemployed and LCC staff members are eligible for concessional rates.

Please enrol me as a member of the Friends of the Queen Victoria Museum and Art Gallery Association

Name:
Name:

Postal Address:


..Postcode:

Telephone:

Email (if applicable):

Please tick if you would like to receive QVMAG Friends information via email

Names and ages of children included in family memberships:
Name: Age:
Name: Age:
Name: Age:
Name: Age:

Extra donation $

Amount enclosed $

Please make cheques payable to:
Friends of the Queen Victoria Museum and Art Gallery

Cheque Cash Mondey Order Visa Mastercard

Enter your credit card number:

Expiration date: / (mm/yyyy)

Cardholder's name (please print):

Signature: ______________________________________ Date:

and mail to:

Friends of the Queen Victoria Museum and Art Gallery
Queen Victoria Museum and Art Gallery
PO Box 2076
Launceston, Tas 7250
AUSTRALIA

Tel: (03) 6323 3706
Fax:(03) 6323 3783
email: friends@qvmag.tas.gov.au

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