Please print this form, fill in and send with a cheque to:
Guardians of
Pauatahanui Inlet,
PO Box 57034, Mana, Porirua City 5247, New Zealand
I/we would like to join/ renew our membership to the Guardians of Pauatahanui
Inlet and/or make a donation (cross out words that do not apply)
| Name: |
Address:
|
| Phone (day): |
| Phone (a/h): |
| E-mail: |
| Would you like to receive your Newsletter by e-mail? |
Yes/No |
| Membership Fees (please complete as appropriate): |
 Ordinary ($12)
|
|
5 yr membership ($50) |
|
Family ($15) |
|
Family 5 yr membership ($60) |
|
Corporate ($200) |
|
Donation |
|
Total |
|
