Member Details First Name* Last Name* Address City State* Country Post Code* Phone Your primary contact number Email* Membership Conditions Membership Guarantee (please read and agree)* If my application is successful I am aware of my membership guarantee obligations to the company, namely that should the company be wound up while I am a member, or within 12 months of my ceasing to be a member, I may be called upon to contribute $20.00 (my guarantee) towards the costs of the company winding up. Annual Membership Terms (please read and agree) * I am aware that to maintain my membership I will be required to pay a minimal annual membership fee. As at June 2020 it will be $10.00 Membership Period* I am aware my membership is valid for the period 01 July to 30 June each calendar year. This membership will require a renewal prior to 30 June 2020. Payment Options Membership Type* New membership $50.00 Please renew my existing membership $10.00. Payment Options (please select one)* Bank transfer Cheque Cash Bank Transfer: Proston Qld Ltd BSB: 084-763 ACC: 9335 84722 or Send cheque: Prosotn QLD Ltd, Shop 40 Blake St. Proston, QLD 4613 Mailing List do you want to receive our newsletter and occasional announcements? Captcha (please answer)* 6 × 2 = ?