Membership form

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Annual Membership Application & Renewal Form

If you would prefer to print a hard copy of our membership form, please download it here.

You can return your form to:

Williamstown Historical Society

PO Box 189

Williamstown, VIC, 3016

Membership form

Online Annual Membership Application & Renewal Form

Please complete all details and submit your application

Membership Form

Primary Member Registration

Primary Member Registration

Date

First Name:

Last Name:

Address

Address - Line 2

Suburb

State

Postcode

Email Address

Phone Number

Additional Member Registration

Additional Member Registration (Complete ONLY for Family Memberships if required)

Newsletters will be emailed to this member IN ADDITION to the person listed as the Primary member.

First Name

Last Name:

Email Address:

Phone Number:

Line

Membership

RENEW an Existing Membership

NEW Membership

Membership

Single Membership $20

Family Membership $30

Donation

Total

Payment Method

Cash

Cheque

Card

Direct Debit

How to pay:

Cash/Cheque/Card: In person at the office

Direct debit :

Bendigo Bank

Account Name: Williamstown Historical Society

BSB: 633 000. Account: 15425 4015

Reference: Your first and last name and 'Mship'

Additional comments

Thank you for your support

Thank you for your support of our organisation