Gifts or Fees – Individual Complete this form to let us know the details of payment you have made. Individual Renewal Date MM slash DD slash YYYY 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)NameThis field is for validation purposes and should be left unchanged. Δ
