Online Membership Form – Gift Membership – Online Payment by Credit Card/Debit Card

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Gift Membership - Online Payment by Credit Card/Debit Card

Payment Method
- Stripe
Data items marked with an asterisk (*) are required.
Payer's First Name * Required
Payer's Last Name * Required
Payer's Email Address * Required
Click here for more information about Subscription Rates
More information
- FAMILY HOUSEHOLD - $30.00 per year (A Family Household is a household consisting of two or more adults without any children where at least one adult is not eligible for a concession, or one or more adults with one or more children).
- SINGLE ADULT HOUSEHOLD - $20.00 per year (A Single Adult Household is a household consisting of a single adult who is not eligible for any concessions).
- CONCESSION HOUSEHOLD - $15.00 per year (A Concession Household is a household consisting of one or more adults where all members of the household are eligible for a concession, i.e. Pensioners, Seniors Card holders, Full-time Students, and Apprentices).
Using this Form
Once you have selected the type of membership you would like, you will be asked to enter the names to appear on the Membership Card(s), any email addresses, and the postal address details.
Type of Membership * Required
- Family Household: $30.00 per year
- Single Adult Household: $20.00 per year
- Concession Household: $15.00 per year
Number of Adults in the Household * Required
Please enter a number from 1 to 4.
Number of Children under 15 * Required
Membership Expiry Date
I wish to make a donation to the FOCIS Churchill Island Heritage Fund as part of my subscription * Required
- Yes
- No
Donation Amount * Required
Minimum Donation
Please note: The minimum donation amount is $2.00.
Click here for information about the Heritage Fund
More information
- Members of the Society and members of the public are invited to donate to the FOCIS Churchill Island Heritage Fund.
- The purpose of the Fund is to help the Society address its principal purpose which is: The promotion of the moveable cultural heritage of Churchill Island.
- The Fund is an endorsed DGR (Deductible Gift Recipient) fund with the Australian Taxation Office (ABN: 78667051020).
- The Fund is listed on the Register of Cultural Organisations maintained under Subdivision 30-B of the Income Tax Assessment Act 1997.
- Donations to the Fund of $2.00 or more are tax-deductible.
- The Friends of Churchill Island Society Inc. is a recognised charity and is registered with the Australian Charities and Not-for-profits Commission (ACNC).
- A Tax Receipt will be issued for each donation of $2.00 and above.
Subscription
Donation
Gift Recipient's Name for Membership Card - First Adult Member * Required
Gift Recipient's Email Address - First Adult Member
Gift Recipient's Name for Membership Card - Second Adult Member * Required
Gift Recipient's Email Address - Second Adult Member
Gift Recipient's Name for Membership Card - Third Adult Member * Required
Gift Recipient's Email Address - Third Adult Member
Gift Recipient's Name for Membership Card - Fourth Adult Member * Required
Gift Recipient's Email Address - Fourth Adult Member
Gift Recipient's Name for Membership Card - Single Adult Member * Required
Gift Recipient's Email Address - Single Adult Member
Gift Recipient's Name for Membership Card - First Concession Member * Required
Gift Recipient's Email Address - First Concession Member
Gift Recipient's Name for Membership Card - Second Concession Member * Required
Gift Recipient's Email Address - Second Concession Member
Gift Recipient's Name for Membership Card - Third Concession Member * Required
Gift Recipient's Email Address - Third Concession Member
Gift Recipient's Name for Membership Card - Fourth Concession Member * Required
Gift Recipient's Email Address - Fourth Concession Member
Gift Recipient's Postal Address - Line 1 * Required
Gift Recipient's Postal Address - Line 2
Gift Recipient's Suburb, Town, or City * Required
Gift Recipient's State, County, or Province * Required
Gift Recipient's Post Code * Required
Gift Recipient's Country * Required
Credit Card/Debit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total Amount Owing
$ 0.00
Once you press the Submit button, this amount will be charged to your Credit Card/Debit Card. Please be patient. It takes a few seconds for your card payment to be processed.
Comments (optional)
I agree to the terms and conditions below. * Required
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Membership Terms and Conditions

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Last updated on: 4th February, 2021

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Gift Membership - Online Payment by Credit Card/Debit Card

Once you press the Submit button, this amount will be charged to your Credit Card/Debit Card. Please be patient. It takes a few seconds for your card payment to be processed.

Membership Terms and Conditions

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