Royal Geographical Society of South Australia Inc
Mortlock Wing, State Library of South Australia
North Terrace, Adelaide SA 5000, Australia
Tel/Fax: (08) 8207 7265
Email: admin@rgssa.org.au
Postal address: PO Box 3661,Rundle Mall Adelaide SA 5000, Australia
Annual Renewal of Membership form
New member click here!
Please write down if have you any suggestions about improvement of the RGSSA services? Do you know you may subscribe for a maximum of three years at the current full annual subscription less $5 discount per year for payments made in advance?
 
Family name
Initials
 
Given name(s)
Title
If your Postal address or e-mail has changed please add it below
Street no & name or PO Box no
City/Suburb/Town
State Post Code
Country
 
E-mail address Daytime telephone no
Occupation
Special interests
*Ordinary/Overseas ($65) *Family ($80) *Country/Interstate($60) Concession ($50)
Institutional ($90) Life ($1,000) Affiliate ($35)

(Centrelink Pensioner cardholders only)

Student  ($25)
Amount in Australian Dollars
*Discount of $5 each year if payment received by last day of Feb.
Payment by Cheque no.
(OR) Payment by credit card:
Visa card Master card
Card No.
Expiry date
Name on card
I would like to make a donation to the RGSSA Trust fund and/or to the RGSSA Centenary Library Fund (All contributions of $2.00 and over are Tax deductible-receipt will be sent to you)
RGSSA Inc Trust Fund
$100 $50 $25 Other
RGSSA Inc Centenary Library Fund
$100 $50 $25 Other
Signature:
_ _ _ _ _ _ _ _ _ _ _ _ 
Total amount in Australian Dollars :
 
Date:

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