Mosaic Association of Australia: Become a MAANZ Member

Become a Member

Complete this form and forward your payment by fax, phone or post.

Please allow three weeks for us to process your membership

Section 1 — Your Details

Name:

Address:

Postcode:

Phone:

Mobile:

Email:

I am a:

(Tick all that apply)

Mosaic Artist
Mosaic Business
Mosaic Enthusiast
Other

Section 2— Mosaic Association Of Australia

Item		Cost (inc GST)
Become a member of MAANZ	Register	$110.00
Upgrade to Professional Status**	Upgrade	$25.00

Payment for MAANZ membership is by cheque, money order or credit card*.

* all credit card transactions incur an additional 5% fee

Section 3— Payment Method (choose one of the following FOUR options)

	Cheque payable to: Mosaic Association of Australia and New Zealand	Money order payable to: Mosaic Association of Australia and New Zealand

	Credit card (will incur 5% fee):	Direct Deposit Send an email to the treasurer requesting bank information
*Please note that we do not send receipts. If you would like a receipt, please send us a self addressed stamped envelope.*

Your privacy and security is important to us, please print a copy of this form and complete this part offline. You may Post, phone or fax this section through.

v This section to complete offline v

Card No:

Name on Card:

Expiry Date:

Cardholder address:

Charge Amount ($)
(please add 5% fee):

Signature:

^ This section to complete offline ^

** Professional Status: Life Members are invited to upgrade to professional status! For an additional annual fee of $25, MAANZ Lifetime Members receive a professional link to their website on the MAANZ Professional Links Page. If you choose to upgrade your membership, please contact the president.

PRINT a copy and forward with payment to:

Mosaic Association of Australia and New Zealand
PO Box 3943 Manuka ACT 2603

or Fax to: (02) 6258 0140

MAANZ Incorporation Number: 98773337
MAANZ ABN: 89 676 625 625