Membership Application Form

Cape Bird Club and BirdLife South Africa

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 Club,  P.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 R350 R180 R180

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 . . .     /       / R75 R
Child 1 . . .     /       / R20 R
Child 2 . . .     /       / R20 R

 

Total amount remitted

BLSA and Cape Bird Club fees . R
Family Members fees . R
Magazine subscriptions     (optional) . .
Africa - Birds and Birding (6 issues p.a.) R160 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    X        Diners     X        Amex    X
Name of Card holder: Signature:

Club membership rates are valid until 30 June 2012. 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 address above.

Top of page  Back  Home