Application for Individual Membership Renewal

Piye Inc.

(Incorporated under the Australian Associations Incorporation Act 2009)

Your Details
Title  Mr Mrs Ms Dr Prof
* Firstname * Surname
* Address
Suburb * Postcode
Phone(h) Phone(m)
Phone(w) * Email
* Country
 
Payment of AU$50 annual membership fee


* Payment Options
 One Time Payment
* I would like to pay amount in
  AUD USD EURO
* Amount to be transferred
   
Please note: Membership payments are not tax-deductible.
 Direct Debit/ Bank Transfer
Bank Name: Commonwealth Bank
Bank Location: Sydney, Australia
Account Name: PIYE Incorporated
Account Number: 10484047
BSB#: 062009
Swift Code (Outside Australia): CTBAAU2S
 Cheque/ Money Order - payable to PIYE Incorporated.
Print and mail this form along with your payment to:

The Treasurer
Piye Incorporated
33 Ness Avenue
Dulwich Hill
NSW Australia 2203

 Pay by Credit Card or Bank Transfer via PAYPAL.
(PAYPAL will process amount in AU$)
I have completed my AU$50 payment using one of the above methods.
* Sign here or print name  



We would appreciate a confirmation of your payment.
Please email us on info@piye.org.au

Thank you for your support

 


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