Renewal form

Renewal Form

Australian Society for Sports History

Please print out this form and return with payment to the address below

1. Select Membership type and the years you wish to renew for:

Individual Member	$50	2008
Concession rate (unwaged/student/retired)	$25	2009
Institutional Member	$100	2010
Life Member (Australia/New Zealand)	$500	2011
Life Member (overseas)	$750	2012

Update your membership details here. If no change, please leave blank.

2. Name

3. Address

4. Phone/Fax

5. Email

Please make cheques payable to "ASSH"
Please charge my Bankcard/MasterCard/VISA account

6. Amount

7. Expiry date

7. Credit card number

8. Signature

9. Cardholder name & address

All categories must be filled in for this to be a legal transaction.

Please note that ASSH is not registered to collect the GST. Our ABN is: 18003835298

Please forward membership form with payment to:

Gary Osmond
ASSH Membership & Claims Officer
School of Human Movement Studies
The University of Queensland QLD 4072
AUSTRALIA

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