Name (required)

Surname (required)

Address (required)

Suburb (required)

State (required)

Postcode (required)

Phone number (required)

E-mail (required)

Membership type (required) ---Individual - $50Concession (Student/Pensioner/Senior) - $25Junior (16 years and under) - $15

Is this a renewal? ---YesNo

Would you rather receive the newsletter by email or post? ---E-newsPrint

Subscription for Choir ($10.00 in addition to membership) ---YesNo

Age range (required) ---20 or less21-3536-5051-65more than 65

Are you interested in assisting with the activities of the Society? (required) ---YesNo

Message (optional)

Payment Method (required) Bank TransferSquare Online CheckoutPay in the Office via card or cash

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Annual membership costs $50 for individuals, $25 for concession and $15 for people under 16. Your membership will be VALID UNTIL THE END OF 2023. Please note that your membership will not be valid until we receive confirmation of payment.

To finalise your payment, please visit the Dante Office during office hours to pay via card/cash, or via direct deposit into the following account:
Dante Alighieri Society
BSB: 082 902
Account No: 515 003 825
(Please include your surname and initials as reference when paying by EFT)

By filling in this form, you agree to abide by the rules and regulations of the Dante Alighieri Society (copies are available from the office on request).

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