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CISS meets on the 4th Saturday of every month - venue: see Announcements page - Members $5, Non members $7, All are welcome


Join us

 

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CISS Membership Application Form                     

Date:      _______________

 
Name:___________________________________________________________
 
Address:ญญญ_____________________________________________________
           _____________________________________________________
 
Postcode:  ________ Country:______________________
 
Home Phone:_______________       Fax: _____________________
 
Work Phone:_______________       Fax: _____________________
 
Occupation:________________________________________________
 
How can we help you?____________________________________________
                    ____________________________________________
How can you help us?____________________________________________
                    ____________________________________________
Subscription rates (includes 6 newsletters):
Single $40, Double $50                   $___________
                                    
Donation                                 $___________
                                   
Total                                    $___________

Please print off this FORM and fill in the details. Include a cheque or postal order for the amount you wish to pay. Donations of $2 and more are tax deducible: Cert. No. AF 1595C SF 6971. All amounts shown are in Australian Dollars. Please make cheques payable to: The Cancer Information & Support Society.

 
----------------cut-here-and-paste-address-on-envelope---------
 
   The Cancer Information & Support Society 
   6/56 Chandos Street                     
   St. Leonards NSW 2065                   
   AUSTRALIA                         
  Please report all suggestions and problems to Webmaster@ciss.org.au quoting pagename "join.html" which was last modified on Tuesday 2/10/07
ฉ Copyright CISS, 1999-2007 - copy permission granted for nonprofit use.