To the Hon. Secretary, Postal Stationery and Postal History Society of Australia Inc., GPO Box 4, ADELAIDE, SOUTH AUSTRALIA, 5001.

I hereby make application for MEMBERSHIP of the Postal Stationery and Postal History Society of Australia Inc., situated at ADELAIDE, and declare that if elected I will abide by the Society's Rules, now in force or at any future time passed.

NAME
Mr./Mrs./Miss./Ms................................................
ADDRESS..........................................................
POSTAL ADDRESS (for publication to members ONLY*)
.................................................................
.................................................................
* If so desired the applicant's postal address may be shown as "c/o Society" any mail addressed to the member will then be re-directed by the Secretary.

Occupation.................... Telephone no.....................
Business Address.................................................
Telephone No.....................................................

Names and addresses of TWO persons to whom reference can be made:-

(a) Name......................... Address.......................... ................................. ................................. Telephone No.....................

(b) Name......................... Address.......................... ................................. ................................. Telephone No.....................

I am a member of another Society (Please state which, if applicable)
...................................................................
...................................................................
My collecting interests are:-......................................
...................................................................

I enclose herewith the sum of $....... being FULL/HALF YEARS Subscriptions, plus joining fee. I am aware that the financial year begins on 1st. JULY. I agree to pay the full years subscription amount IN ADVANCE until such time as I forward my written resignation, I also understand that should my subscriptions remain unpaid by the last day of September for the year to which they relate my membership will be terminated.

Signature of Applicant............. Date..............
First Reading........ Second Reading......... Membership No.......

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