Membership Application Form

Cape Bird Club and BirdLife South Africa

 

EFT payments are best or direct deposit into the BLSA account, see below.

Cheques should be non transferable and made payable to BirdLife South Africa.

Post this application form and cheque / deposit slip to;

Membership Secretary,  Cape Bird ClubP.O.Box 2113, Clareinch, 7740.

Membership is for a period of 12 months from the date of joining and renewable each year.

 

Personal Detail

Title: Prof/Dr/Mr/Mrs/Ms/Miss Initials: Language:  Eng / Afrik
Name: Date of Birth:      /      /
Surname:
Postal Address:
Postal code:
Tel Home: Tel Work:
Fax:
Cell:
Email:

Membership Detail

Membership fee includes both BirdLife South Africa and the Cape Bird Club membership.

Club Individual Senior Citizen Student
Total fees R370 R200 R200

Senior Citizens: 60 years and older.  Student: 17 years and younger or over 18 and in full time study.

 

Family Members Detail

Family Member Title Name Surname Date of birth Fee Amount paid
Spouse / Partner . . .     /       / R80 R
Child 1 . . .     /       / R25 R
Child 2 . . .     /       / R25 R

 

Total amount remitted

BLSA and Cape Bird Club fees . R
Family Members fees . R
Magazine subscriptions     (optional) . .
BirdLife South Africa's magazine
African Birding  (6 issues p.a.)
R205 R
.

Total amount remitted

R

Cheques should be non transferable and made payable to BirdLife South Africa.

Credit Card Payment

. . . . . . . . . . . . . . . .
Expiry date:       /            CVC No. Visa/Master           Diners     X        Amex    X
Name of Card holder: Signature:

          Club membership rates are valid until 30 June 2013.  Rates applicable in South Africa.
                                         Other enquiries to membership@birdlife.org.za

 

Direct Bank Deposit

Bank Bank Branch Account Name Account Number Branch Code
FNB Randburg, JHB BirdLife South Africa 620 6750 6281 25 40 05

Remember to attach the Deposit slip as proof of payment with the Application form, when posting your
                     membership application to the Membership Secretary at the address above.

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