Thank you for generous patronage as a financial member of Manning Clark House!
To become a member, renew your membership or update your current contact details, please complete the information requested below, marking your email or envelope ‘membership.’ Print this page and then email it to manningclarkhse@gmail.com Alternatively, post the completed form to: The Treasurer, Manning Clark House, PO Box 3096, Manuka ACT 2603.
Date submitted:
Name:
Address:
Telephone nos:
Email:
Interest in volunteering? (List skills and/or contact volunteer coordinator Fleur Millar on 0421 187 688.
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Membership fees (tick relevant box). Members receive concessions at events.
Are you renewing your membership? Are you a new member? (Circle one)
- Individual member/couple 12 months – $80 couple, $50 single
- Recipients of government income support, full-time students/couples where both are in this category 12 months – $50 couple, $35 single
- Corporate rate $100/ organisational rate – $50
Manning Clark House Inc. is registered as a charity with the Australian Charities and Not-for-Profits Commission ABN 39 997 015 544. Donations over $2 are tax deductible.
Donation to Manning Clark House Inc – please indicate $…………………………..
Payment options (preferred payment is by credit card or direct bank deposit) or you can post a cheque.
Card type:
Card number:
Expiry date (month and year):
Name on card:
Amount to be debited:
Signature and date :
You can deposit directly online into the MCH Westpac bank account in Manuka in the following way:
ACCOUNT NAME: Manning Clark House
BSB: 032 729 ACCOUNT NUMBER: 167805
TRANSFER DESCRIPTION: Mem XXXXX (1st 4 letters of surname + initial) or if includes donation: MemD XXXXX Please tell us the DATE OF TRANSFER: dd/mm / yyyy
If you wish to, please write (or attach) a short statement about the kinds of activities you would like to see MCH conduct in the future.
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Manning Clark House Inc 