EcoNetwork Port Stephens Inc

Complete the online application form below and click [Submit].

Name:
Phone/Fax:
Email Address:
Mailing Address:

Annual Fees
	$10.00 - Individual Membership / $5.00 Student Membership.
Affiliation
	$25.00 - Environmental & Community-based Affiliates.
	$50.00 - Commercially Based Affiliation.
I wish to apply for membership with EcoNetwork - Port Stephens Inc., agree to abide by the Model Rules of Incorporation - NSW Office of Fair Trading and hereby enclose the appropriate Annual Fee.

Alternatively, click here to download the form in PDF format. Complete and mail to:
The Secretary, EcoNetwork - Port Stephens Inc., PO Box 97, Nelson Bay, NSW 2315