Gifts or Fees – Individual

Complete this form to let us know the details of payment you have made.

Individual Renewal

Date

Membership Status(Required)

New Member

Membership Renewal

Name(Required)

First Last

Payment methods(Required)

Cheque (Post to: The Secretary – CMA Vict, 368 Ben-warren Rd, Baddaginnie, Vic, 3670)

Direct Deposit Payment with your name in the ‘Comments’ section BSB 633 000 Account 127 403 079

Amount Paid(Required)

Comments

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Name(Required)

First Last

Email(Required)

Select the person to be sent your enquiry:(Required)

Vic President

Vic Treasurer

Vic Secretary

Bushy Craig Ruby

Vic Prayer

Vic Web

Bikes for Pastors

other

Question(Required)

Let us know how can we can help

Phone

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