Name

Please tick to confirm *

I, hereby apply to renew my membership of the above named Incorporated Association for the annual fee of $10.00. Annual fee renewals are payable in July of each year. In the event of my admission as a member, I agree to maintain good standing in the community and be bound by the rules of the Association.
I have deposited my $10 membership fee to: The SHIFT Project Inc. Byron, Bank: Westpac, BSB: 032 573 Account: 373054

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