Membership

To sign up, please fill in the form below. If you'd like to make a donation, please contact us.

Payment may be made:

• By direct deposit, to our Bendigo Bank account:
  BSB: 633-000
  Account: 135047967
  Reference: Your surname and the word "membership"
• By cheque, made out to IKPS Inc and mailed to:
  The Secretary
  110 Brass Road
  Mount Forbes, Qld 4340

Surname:
Adults' names:
Childrens' names: (if you wish to include them in the membership)
Address:
Suburb:
Postcode:
Email address:
Home phone:
Mobile phone:
Are you a registered Wildlife Carer?	Yes No
IF YES which group are you registered with?
Which species are you experienced in caring for?
Do you wish to become a carer?	Yes No
Type of membership required:	Family (2 adults and all children under 15) - $30 Adult - $20 Junior (aged 15-18) - $10 Note: A $5 discount applies to all fees paid before 1st Feb.